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Poveda A, López-Pousa A, Martín J, Del Muro JG, Bernabé R, Casado A, Balañá C, Sanmartín O, Menéndez MD, Escudero P, Cruz J, Belyakova E, Menéndez D, Buesa JM. Phase II Clinical Trial With Pegylated Liposomal Doxorubicin (CAELYX(R)/Doxil(R)) and Quality of Life Evaluation (EORTC QLQ-C30) in Adult Patients With Advanced Soft Tissue Sarcomas: A study of the Spanish Group for Research in Sarcomas (GEIS). Sarcoma 2011; 9:127-32. [PMID: 18521419 PMCID: PMC2395634 DOI: 10.1080/13577140500287024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2005] [Revised: 07/05/2005] [Accepted: 07/22/2005] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pegylated liposomal doxorubicin (PLD), a formulation with pharmacokinetic differences with respect to doxorubicin (DXR), might benefit patients with advanced soft tissue sarcoma (STS) pretreated with DXR. PATIENTS AND METHODS Patients with measurable and progressive STS received PLD at 35 mg/(2) every 3 weeks. Quality of life before and during treatment was assessed with EORTC QLQ-C30. RESULTS Twenty-eight patients, 22 DXR-pretreated, were given 140 cycles (median 3, range 1-18). Activity in 27 patients (5 GIST): one complete and one partial remission (both non-GIST and without prior DXR), 12 stabilizations and 13 progressions (response rate 7.4%, 95% CI: 0-17%). Grade 3 toxicity: palmar-plantar erythrodysesthesia (19% of patients), stomatitis (4%) or cutaneous (4%). Neutropenia grade>/=3 was detected in 16% of patients. Median relative dose intensity was 95%. Progression-free rate at 3 and 6 months was, respectively, 48 and 22%, median progression-free survival 5.8 months and median overall survival 8.7 months. QLQ-C30 at baseline and at weeks 6-11 in 23 and 13 patients, respectively, showed good reliability and validity. Quality of life did not seem to worsen during therapy. CONCLUSIONS PLD did not induce objective remissions in 22 STS patients pretreated with DXR, but progression-free rate figures support the use of this agent in patients who have not progressed under a DXR-containing regimen. The toxicity observed was comparable to that of other PLD schedules.
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Affiliation(s)
- A Poveda
- Instituto Valenciano de Oncología Valencia Spain
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Losa R, Fra J, López-Pousa A, Sierra M, Goitia A, Uña E, Nadal R, Del Muro JG, Gión M, Maurel J, Escudero P, Esteban E, Buesa JM. Phase II study with the combination of gemcitabine and DTIC in patients with advanced soft tissue sarcomas. Cancer Chemother Pharmacol 2006; 59:251-9. [PMID: 16736150 DOI: 10.1007/s00280-006-0263-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2006] [Accepted: 05/02/2006] [Indexed: 11/30/2022]
Abstract
PURPOSE Based on the promising results of a Phase I study with a combination of gemcitabine and DTIC performed in advanced soft tissue sarcoma (ASTS) patients, and due to the limited efficacy of second or third line therapies in those patients, we designed a Phase II study to determine the activity of this new regimen. METHODS Patients with ASTS, measurable disease, pretreated with chemotherapy, received gemcitabine 1,800 mg/m2 infused over 180 min followed by DTIC 500 mg/m2 (one cycle), every 2 weeks. The pharmacokinetics (PK) of gemcitabine and 2',2'-difluorodeoxyuridine (dFdU), and the accumulation of gemcitabine triphosphate (dFdCTP) by peripheral blood mononuclear cells were studied. The influence of the sequence of administration on those parameters was examined to exclude potential drug interactions. RESULTS Twenty-six patients received a total of 158 cycles (mean four cycles, range 1-18). Grade 3-4 anemia (23% of patients), granulocytopenia (46%) or thrombocytopenia (12%), and grade 3 increase in AST (18%), ALT (21%), or gamma-glutamyl-transferase (9%) were noted. Response rate in 23 patients was 4% (95% CI: 0-24%), and in 8 of 11 patients stable disease lasted > 6 months. Progression-free rate (PFR) at 3 and 6 months was, respectively, 48 and 28%, and median overall survival 37 weeks. Pooled data from the Phase I and Phase II studies showed clinical benefit in patients with leiomyosarcomas (LMS) (57%) and malignant fibrous histiocytomas (MFH) (33%). The sequence of administration did not influence PK of gemcitabine or dFdU. There was a trend (P = 0.11) toward a lower accumulation of dFdCTP when DTIC preceded gemcitabine. CONCLUSIONS Although the remission rate was low, PFR figures indicate that this regimen has activity in patients with ASTS. It should be compared with DTIC, or other gemcitabine-containing combinations, in patients with LMS or MFH, to determine whether this combination offers advantages in PFR or in overall activity.
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Affiliation(s)
- R Losa
- Servicio de Oncología, Hospital Central de Asturias, 33006, Oviedo, Spain
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Martin J, Poveda A, Llombart-Bosch A, Ramos R, García Del Muro J, Martinez J, De Juan A, Maurel J, Losa F, Buesa JM. Prognostic value of pathologic variables and mutations type in patients with complete surgical resection of gastrointestinal stromal tumors (GIST). A GEIS study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Martin
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - A. Poveda
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - A. Llombart-Bosch
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - R. Ramos
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - J. García Del Muro
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - J. Martinez
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - A. De Juan
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - J. Maurel
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - F. Losa
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
| | - J. M. Buesa
- Hospital Son Dureta, Palma de Mallorca, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalán de Oncología, Barcelona, Spain; H. Miguel Servet, Zaragoza, Spain; H. Marqués de Valdecilla, Santander, Spain; H. Clinic, Barcelona, Spain; H. Creu Roja, L'Hospitalet, Spain; Hospital Central de Asturias, Oviedo, Spain
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