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Takayama K, Uchino J, Fujita M, Tokunaga S, Imanaga T, Morinaga R, Ebi N, Saeki S, Matsukizono K, Wataya H, Yamada T, Nakanishi Y. Phase I/II Study of Docetaxel and S-1 in Previously-Treated Patients with Advanced Non-Small Cell Lung Cancer: LOGIK0408. J Clin Med 2019; 8:jcm8122196. [PMID: 31842381 PMCID: PMC6947543 DOI: 10.3390/jcm8122196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 11/20/2022] Open
Abstract
Background: As docetaxel plus S-1 may be feasible for cancer treatment, we conducted a phase I/II trial to determine the recommended docetaxel dose and the fixed S-1 dose (phase I), as well as confirm the regimen’s efficacy and safety (phase II) for previously-treated patients with advanced non-small cell lung cancer. Methods: Patients ≤75 years with performance status ≤1 and adequate organ function were treated at three-week intervals with docetaxel on day 1 and 80 mg/m2 oral S-1 from days 1–14. The starting docetaxel dose was 45 mg/m2 and this was escalated to a maximum of 70 mg/m2. In phase II, response rate, progression-free survival (PFS), overall survival (OS), and safety were assessed. Results: The recommended doses were 50 mg/m2 docetaxel (day 1) and 80 mg/m2 S-1 (days 1–14). Grades 3 and 4 leukocytopenia and neutropenia occurred in 44% and 67% of patients, respectively. Nonhematologic toxicities were generally mild. Overall response to chemotherapy was 7.7% (95% confidence interval (CI), 1.6–20.9%), and median PFS and OS were 18.0 weeks (95% CI; 11.3–22.9 weeks) and 53.0 weeks, respectively. Conclusion: Fifty mg/m2 docetaxel plus 80 mg/m2 oral S-1 had a lower response rate than anticipated; however, the survival data were encouraging. A further investigation is warranted to select the optimal patient population.
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Affiliation(s)
- Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8190395, Japan; (K.T.); (Y.N.)
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
| | - Junji Uchino
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
- Correspondence: ; Tel.: +81-75-251-5513
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka 8140133, Japan;
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka 8190395, Japan;
| | - Tomotoshi Imanaga
- Department of respiratory disease, Nippon Steel Yawata Memorial Hospital, Kitakyushu 8058508, Japan;
| | - Ryotaro Morinaga
- Department of Medical Oncology, Oita University Faculty of Medicine, Yuhu 8795593, Japan;
| | - Noriyuki Ebi
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, 8208505 Japan;
| | - Sho Saeki
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto 8608556, Japan;
| | - Kazuya Matsukizono
- Department of Internal Medicine, Kagoshima City Hospital, Kagoshima 8908544, Japan;
| | - Hiroshi Wataya
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka 8100001, Japan;
| | - Tadaaki Yamada
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8190395, Japan; (K.T.); (Y.N.)
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Kawano Y, Okamoto I, Fukuda H, Ohe Y, Nakamura S, Nakagawa K, Hotta K, Kiura K, Takiguchi Y, Saka H, Okamoto H, Takayama K, Semba H, Kobayashi K, Kenmotsu H, Tsuboi M, Yamamoto N, Nukiwa T, Nakanishi Y. Current status and future perspectives of cooperative study groups for lung cancer in Japan. Respir Investig 2014; 52:339-347. [PMID: 25453377 DOI: 10.1016/j.resinv.2014.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/06/2014] [Accepted: 06/17/2014] [Indexed: 06/04/2023]
Abstract
The performance of scientifically and ethically valid prospective clinical trials is the only means by which to obtain reliable clinical evidence that can improve clinical practice and thus the outcome of patients with lung cancer. The efficacy of treatment for advanced lung cancer remains limited; many cooperative study groups for lung cancer have been established in Japan since 1990s, and they have completed several landmark investigator-initiated clinical trials. This review highlights eight active Japanese cooperative study groups for lung cancer and summarizes their achievements made through clinical trials. In addition to their benefits, the existence of multiple study groups for a single disease such as lung cancer presents several challenges including the provision of infrastructure to ensure the scientific integrity of trial results, the unnecessary duplication of effort and the wasting of limited resources, and the accrual and completion of large-scale phase III trials in the shortest possible time. Collaboration among Japanese cooperative groups has recently increased in order to overcome these challenges. Although institutional barriers to the performance of such large intergroup trials remain, further harmonization and collaboration among cooperative groups will be vital in allowing Japanese investigators to make further important contributions for the development of new lung cancer therapies.
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Affiliation(s)
- Yuko Kawano
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; West Japan Oncology Group (WJOG), Japan; Lung Oncology Group in Kyushu (LOGiK), Japan.
| | - Isamu Okamoto
- Center for Clinical and Translational Research, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan; Lung Oncology Group in Kyushu (LOGiK), Japan.
| | - Haruhiko Fukuda
- Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Yuichiro Ohe
- Division of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan; Thoracic Oncology Research Group (TORG), Japan.
| | - Shinichiro Nakamura
- West Japan Oncology Group Data Center, 1-5-7-304 Motomachi, Naniwa-ku, Osaka 556-0016, Japan.
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan.
| | - Katsuyuki Hotta
- Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; Japan Clinical Oncology Group (JCOG), Japan; Okayama Lung Cancer Study Group (OLCSG), Japan.
| | - Katsuyuki Kiura
- Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; Japan Clinical Oncology Group (JCOG), Japan; Okayama Lung Cancer Study Group (OLCSG), Japan.
| | - Yuichi Takiguchi
- Department of Medical Oncology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan; Tokyo Cooperative Oncology Group (TCOG), Japan; Thoracic Oncology Research Group (TORG), Japan; North East Japan Study Group (NEJSG), Japan.
| | - Hideo Saka
- Department of Respiratory Medicine, National Hospital Organization, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan; Central Japan Lung Study Group (CJLSG), Japan.
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen׳s Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, Kanagawa 240-8555, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan; Thoracic Oncology Research Group (TORG), Japan.
| | - Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; West Japan Oncology Group (WJOG), Japan; Lung Oncology Group in Kyushu (LOGiK), Japan.
| | - Hiroshi Semba
- Division of Respiratory Disease, Kumamoto Regional Medical Center, 5-16-10 Honjyo, Chuo-ku, Kumamoto 860-0811, Japan; West Japan Oncology Group (WJOG), Japan; Lung Oncology Group in Kyushu (LOGiK), Japan.
| | - Kunihiko Kobayashi
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan; Tokyo Cooperative Oncology Group (TCOG), Japan; North East Japan Study Group (NEJSG), Japan.
| | - Hirotsugu Kenmotsu
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan.
| | - Masahiro Tsuboi
- Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan; Thoracic Oncology Research Group (TORG), Japan.
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan; Japan Clinical Oncology Group (JCOG), Japan; West Japan Oncology Group (WJOG), Japan.
| | - Toshihiro Nukiwa
- South Miyagi Medical Center, 38-1 Aza-Nishi, Ogawara, Shibata-gun, Miyagi 989-1253, Japan; Tokyo Cooperative Oncology Group (TCOG), Japan; North East Japan Study Group (NEJSG), Japan.
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Center for Clinical and Translational Research, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; West Japan Oncology Group (WJOG), Japan; Lung Oncology Group in Kyushu (LOGiK), Japan.
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Bertino EM, Bekaii-Saab T, Fernandez S, Diasio RB, Karim NA, Otterson GA, Villalona-Calero MA. A phase II study of modulated-capecitabine and docetaxel in chemonaive patients with advanced non-small cell lung cancer (NSCLC). Lung Cancer 2012; 79:27-32. [PMID: 23079156 DOI: 10.1016/j.lungcan.2012.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 09/12/2012] [Accepted: 09/20/2012] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This phase II single-arm trial of docetaxel and capecitabine in previously untreated non-small cell lung cancer (NSCLC) patients was designed to evaluate response rate of this regimen based on promising efficacy data from phase II testing in pre-treated NSCLC patients. The trial also evaluated the correlation between peripheral blood dihydropyrimidine dehydrogenase (DPD) expression and efficacy/toxicity. METHODS Patients with advanced NSCLC (metastatic, including malignant pleural effusion) without prior chemotherapy were enrolled. Baseline DPD screening was performed; patients with baseline DPD level < 0.07 nmol/min/mg protein were considered ineligible for the study. Treatment included a 28-day cycle of docetaxel 36 mg/m(2) on days 1, 8, 15 and capecitabine 1250 mg/m(2)/day in divided doses on days 5-18. Overall response rate (RR) was the primary endpoint with a target RR of 50%. Correlative studies included evaluation of DPD activity levels in peripheral blood and correlation with clinical responses. RESULTS Twenty-eight patients received 86 cycles of treatment (median 3 cycles) and were evaluable for response. The RR was 18% (5 patients); RR did not meet the pre-specified efficacy endpoint and the trial was stopped. 14 patients had stable disease (SD - 50%) and 4 patients had SD >12 weeks. Median time to progression was 3.3 months (95% CI 1.5-4.6 months). Median overall survival was 10.5 months (95% CI: 3.2-15 months). Main toxicities included fatigue, stomatitis and leukopenia. DPD levels ranged from 0.06 to 0.26 nmol/min/mg. The majority of responders (4/5) had DPD levels ≤0.1 nmol/min/mg. Most of the responders (4/5) experienced grade 3 toxicities including leukopenia, dehydration, fatigue, and diarrhea. None of the patients (0/4) with higher DPD levels (> 0.2 nmol/min/mg) had a response. CONCLUSION The response rate for the regimen did not demonstrate sufficient activity and further study of this regimen in this setting is not indicated. Interestingly, the results suggest that low DPD expression may be associated with response to capecitabine but also with increased toxicity.
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Affiliation(s)
- Erin M Bertino
- The Ohio State University Wexner Medical Center, Department of Internal Medicine, Division of Medical Oncology, Columbus, OH, USA
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Jeong TY, Park BK, Lee YW, Cho CK, Yoo HS. Prospective analysis on survival outcomes of nonsmall cell lung cancer stages over IIIb treated with HangAm-Dan. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 13:1009-15. [PMID: 21081039 PMCID: PMC6000501 DOI: 10.3779/j.issn.1009-3419.2010.11.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and objective Non-small cell lung cancer (NSCLC) stages over Ⅲb still remain as an intractable disease. Survival rate of NSCLC stages over Ⅲb could be increased through chemotherapy and radiation, but results are not satisfactory. Oriental medicine herbal formula, HangAm-Dan (HAD) has been developed for anti-tumor purpose and several previous studies have already reported its effects. The aim of this study is to assess HAD's efficacy on prolonging the survival rate of NSCLC stages over Ⅲb. Methods We have administered 3 000 mg of HAD daily to patients. The study included 74 first visit patients of East-West Cancer Center (EWCC) from November 2007 to April 2008, diagnosed with inoperable NSCLC stages over Ⅲb. Among them, 30 patients were in HAD group and 44 patients were in combined group with conventional therapy and HAD. We have observed and analyzed their overall survival. Results Of total 74 patients, overall 1 year, 2 year survival rates and the median survival time were 62.1%, 34.9% and 17.0 months (95%CI: 12.9-21.1). NSCLC stage Ⅲb patients showed higher survival rates than NSCLC stage Ⅳ patients (P=0.408). The 1 year, 2 year survival rates and the median survival time of the combined group were 70.5%, 37.9% and 20.0 months (95%CI: 16.4-24.6). In HAD group, the 1 year, 2 year survival rates and the median survival time were 50.0%, 25.7% and 12.0 months (95%CI: 6.6-17.4). The combined therapy group showed higher survival rates than the HAD group (P=0.034). Each groups treated with HAD for more than 4 weeks showed higher survival rates than those treated for less than 4 weeks, but there was no significant difference (P=0.278). In hazard ratio, the combined therapy group showed lower mortality rate than the HAD group with statistical significance (P=0.040). Conclusion HAD could prolong the survival rate of inoperable NSCLC stages over Ⅲb. HAD is more effective when combined with conventional therapy. In the future, more controlled clinical trials with larger sample in multi-centers are needed to reevaluate the efficacy and safety of HAD.
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Affiliation(s)
- Tae-Young Jeong
- East-West Cancer Center, College of Oriental Medicine, Daejeon University, Daejeon, Korea.
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