Seminars in oncology
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Seminars in oncology · Aug 1997
Docetaxel (Taxotere) and vinorelbine in the treatment of non-small cell lung cancer.
The efficacy and safety of a combination of docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) and vinorelbine were evaluated in two phase II studies including 46 and 39 chemotherapy-naive patients with non-small cell lung cancer, respectively. In the first study, vinorelbine 25 mg/m2 was given on day 1 and docetaxel 100 mg/m2 on day 2, with recombinant human granulocyte colony-stimulating factor support from day 5 until day 12, every 3 weeks. In the second study, docetaxel 75 mg/m2 was given on day 1 and vinorelbine 20 to 25 mg/m2 on days 1 and 5 in a 3-week schedule. ⋯ The overall response rates were 33% and 39%, respectively. It is concluded that combination therapy with docetaxel/ vinorelbine or with docetaxel/vinorelbine/cisplatin has antitumor activity in the treatment of non-small cell lung cancer. Granulocytopenia and febrile neutropenia are the most severe toxicities that limit the usefulness of these regimens.
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Seminars in oncology · Aug 1997
Combination treatment with docetaxel (Taxotere) and platinum compounds for non-small cell lung cancer.
There is a strong rationale for combining docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) and platinum compounds for use in the treatment of non-small cell lung cancer (NSCLC). The compounds are active as single agents and have no overlapping toxicity profiles. The first dose-finding study reported a response rate of 46%, and recommended doses of 75 mg/m2 for docetaxel and 75 to 100 mg/m2 for cisplatin, given concomitantly every 3 weeks. ⋯ Compared with monotherapy, docetaxel/platinum combinations appear to offer the potential for improved response rates in patients with NSCLC. The use of alternating schedules offers the further possible advantage of improving tolerability while retaining effective doses. Further studies are in progress or planned to elucidate optimal doses and schedules.
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Seminars in oncology · Aug 1997
Randomized Controlled Trial Clinical TrialInduction paclitaxel and carboplatin followed by concurrent chemoradiotherapy in patients with unresectable, locally advanced non-small cell lung carcinoma: report of Fox Chase Cancer Center study 94-001.
The paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ)/carboplatin combination has demonstrated promising activity in patients with incurable non-small cell lung cancer (NSCLC). Our exploratory study is designed to evaluate the efficacy of this combination as induction therapy in patients with locally advanced NSCLC, to determine the maximally tolerated doses of paclitaxel and carboplatin administered every 3 weeks during radical thoracic radiation after induction treatment, and to determine the efficacy of granulocyte colony-stimulating factor (G-CSF) priming before induction treatment, followed by conventional G-CSF, compared with conventional G-CSF alone. Eligibility stipulated Karnofsky performance status > or =70%, < or =5% weight loss, and stages IIIB or bulky IIIA NSCLC. ⋯ Induction paclitaxel/carboplatin therapy is active and well tolerated by patients with locally advanced NSCLC. The maximum tolerated doses of paclitaxel and carboplatin during concurrent thoracic radiation and the role of G-CSF priming are not yet established. Severity of esophagitis corresponds to the extent of esophagus irradiated during concurrent thoracic radiotherapy and chemotherapy.
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Seminars in oncology · Aug 1997
ReviewDefining the role of paclitaxel in lung cancer: summary of recent studies and implications for future directions.
Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) was first reported to have activity in advanced non-small cell lung cancer (NSCLC) in 1993 and in advanced small cell lung cancer (SCLC) in 1995. Since these original reports, single-agent activity has been confirmed in both NSCLC and SCLC. In NSCLC, the 20% to 25% response rate and median survival times (approximately 40 weeks) are superior to previously reported single-agent therapy. ⋯ Similarly, paclitaxel and carboplatin combinations produce high response rates when given before surgery for operable patients, and the results of randomized trials are needed to confirm the value of this approach. Paclitaxel-based combinations in advanced SCLC can be administered safely and provide high response rates and relatively long survival times. Randomized trials comparing these combinations to older etoposide/cisplatin combinations are in progress.
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Seminars in oncology · Aug 1997
ReviewFuture perspectives of docetaxel (Taxotere) in front-line therapy.
The recognition that early breast cancer is a systemic disease has led to the development of multimodal treatments incorporating adjuvant hormonal and chemotherapies. Adjuvant strategies have improved the outcome of treatment for early breast cancer, but 50% of women still relapse and develop overt metastatic disease, which is largely incurable. In the search for more effective chemotherapies, the taxoid, docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France), has demonstrated high single-agent activity against metastatic breast cancer, including visceral metastases, and is now in phase III trials of combination adjuvant and front-line therapies. ⋯ The high single-agent activity of docetaxel makes it an excellent candidate for treatments such as induction regimens before high-dose chemotherapy and adjuvant therapies. Short-term treatment regimens such as these should also avoid the cumulative toxicities of docetaxel. It is important that new drugs, such as docetaxel, which have shown promising activity against metastatic disease and could have a significant impact on the natural history of early breast cancer, are investigated as front-line treatments.