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PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
2001-10-12
pubmed:abstractText
Platinum-based chemotherapy is considered standard treatment for advanced non-small-cell lung cancer (NSCLC). However, toxicity of most platinum-based regimens is substantial and requires close monitoring and supportive care. Over the past decade, paclitaxel, docetaxel, vinorelbine, gemcitabine, irinotecan, and topotecan have been introduced into the clinic. These newer agents have shown promising activity against NSCLC with a favorable toxicity profile as single agents. For patients with metastatic NSCLC, palliation is the main goal of therapy. Therefore, treatment should be easy to administer on an outpatient basis. We explored a novel combination therapy avoiding platinum. Patients with recurrent or metastatic NSCLC were treated with intravenous (i.v.) topotecan (0.5-1.0 mg/m(2)/day x 5) and i.v. vinorelbine (20-30 mg/m(2)/day on day 1 and day 5) in 21-day cycles. Dose-limiting toxicity (DLT) was defined separately with or without the addition of granulocyte colony-stimulating factor (G-CSF) support. Twenty-nine patients have been enrolled to date. At i.v. topotecan doses of 0.75-1.0 mg/m(2)/day and i.v. vinorelbine of 25 mg/m(2)/day, neutropenia was frequent but of short duration (<7 days). The DLT of i.v. topotecan (0.85 mg/m(2)) in the absence of G-CSF support was based on myelosuppression with neutropenic fever. With the addition of G-CSF, a DLT has not been reached. Nonhematologic toxicities included mild to moderate fatigue and constipation. An overall clinical response rate of 42% was achieved, with responses noted at all dose levels. At a short median follow-up of 15 months, the median survival for all patients is 13 months. In conclusion, the combination regimen of topotecan and vinorelbine is feasible for outpatient administration and is well tolerated with less toxicity than platinum-based regimens. Preliminary response data demonstrate good tumor activity, suggesting that this regimen could make an excellent palliative treatment for advanced NSCLC.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
0030-2414
pubmed:author
pubmed:copyrightInfo
Copyright 2001 S. Karger AG, Basel
pubmed:issnType
Print
pubmed:volume
61 Suppl 1
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
35-41
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11598413-Adult, pubmed-meshheading:11598413-Aged, pubmed-meshheading:11598413-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:11598413-Carcinoma, Non-Small-Cell Lung, pubmed-meshheading:11598413-Cisplatin, pubmed-meshheading:11598413-Dose-Response Relationship, Drug, pubmed-meshheading:11598413-Drug Administration Schedule, pubmed-meshheading:11598413-Female, pubmed-meshheading:11598413-Follow-Up Studies, pubmed-meshheading:11598413-Humans, pubmed-meshheading:11598413-Infusions, Intravenous, pubmed-meshheading:11598413-Lung Neoplasms, pubmed-meshheading:11598413-Male, pubmed-meshheading:11598413-Middle Aged, pubmed-meshheading:11598413-Neoplasm Staging, pubmed-meshheading:11598413-Sensitivity and Specificity, pubmed-meshheading:11598413-Survival Rate, pubmed-meshheading:11598413-Topotecan, pubmed-meshheading:11598413-Treatment Outcome, pubmed-meshheading:11598413-Vinblastine
pubmed:year
2001
pubmed:articleTitle
Is cisplatin required for the treatment of non-small-cell lung cancer? Experience and preliminary results of a phase I/II trial with topotecan and vinorelbine.
pubmed:affiliation
Multidisciplinary Oncology Center, University Hospital CHUV, Lausanne, Switzerland. roger.stupp@chuv.hospvd.ch
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Research Support, Non-U.S. Gov't, Clinical Trial, Phase II, Clinical Trial, Phase I