Literature DB >> 19520687

Dose-escalating and pharmacokinetic study of a weekly combination of paclitaxel and carboplatin for inoperable non-small cell lung cancer: JCOG 9910-DI.

Katsuhiko Naoki1, Hiroshi Kunikane, Tomoki Fujii, Shuko Tsujimura, Naoya Hida, Hiroaki Okamoto, Koshiro Watanabe.   

Abstract

OBJECTIVE: Combined paclitaxel and carboplatin is a standard regimen for inoperable non-small cell lung cancer (NSCLC). Although an every-3-week schedule is common, weekly paclitaxel is clinically effective for various cancers. A Phase I clinical trial was conducted to determine maximum-tolerated doses (MTDs) for weekly combined paclitaxel and carboplatin, and to evaluate anti-tumor response, toxicity and pharmacokinetics of paclitaxel in patients with inoperable NSCLC.
METHODS: Twenty patients with inoperable NSCLC received weekly carboplatin at area under the curve (AUC) = 2 mg/ml min and paclitaxel. Paclitaxel was escalated if MTD was not reached. Three patients each were entered at levels 1 and 2 (level 1, paclitaxel 50 mg/m(2) and carboplatin AUC = 2 mg/ml min; level 2, 60/2), six at level 3 (70/2), five at level 4 (80/2) and three at level 5 (90/2).
RESULTS: One patient had grade 4 (G4) neutropenia at level 2, one had G3 hepatic toxicity at level 3 and one had G3 cardiac toxicity at level 4. MTD was not reached for all dose levels. Response rate (RR) was 35% (7/20) and median survival was 11.1 months. Severe neutropenia (G3 and G4) was seen in seven patients associated with greater AUC, peak concentration (C(max)) and the duration of plasma concentration >50 ng/ml of paclitaxel.
CONCLUSIONS: Weekly combined paclitaxel (up to 90 mg/m(2)) and carboplatin (AUC = 2 mg/ml min) was well tolerated. A higher dose intensity of paclitaxel can be given, and RR and survival are not less than the every-3-week protocol. The weekly regimen is an alternative for untreated inoperable NSCLC patients.

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Year:  2009        PMID: 19520687     DOI: 10.1093/jjco/hyp059

Source DB:  PubMed          Journal:  Jpn J Clin Oncol        ISSN: 0368-2811            Impact factor:   3.019


  3 in total

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Journal:  J Natl Cancer Inst       Date:  2015-02-16       Impact factor: 13.506

2.  Rationally designed treatment for solid tumors with MAPK pathway activation: a phase I study of paclitaxel and bortezomib using an adaptive dose-finding approach.

Authors:  Janice M Mehnert; Antoinette R Tan; Rebecca Moss; Elizabeth Poplin; Mark N Stein; Mika Sovak; Kelly Levinson; Hongxia Lin; Michael Kane; Murugesan Gounder; Yong Lin; Weichung Joe Shih; Eileen White; Eric H Rubin; Vassiliki Karantza
Journal:  Mol Cancer Ther       Date:  2011-06-16       Impact factor: 6.261

3.  Paclitaxel exposure-toxicity analysis reveals a pharmacokinetic determinant for dose-limiting neutropenia in East-Asian solid tumor patients: results from two prospective, phase II studies.

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Journal:  Cancer Chemother Pharmacol       Date:  2022-08-03       Impact factor: 3.288

  3 in total

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