Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Purpose: Since the combination of cisplatin plus gemcitabine (CG) had a significant survival advantage for the treatment of patients with chemotherapynaïve advanced or metastatic non-small cell lung cancer (NSCLC), CG combination have been evaluated with different schedules. However, the best schedule is still unclear. We designed to compare the efficacy and toxicity of CG combination chemotherapy in two different doses of gemcitabine (1,000 or 1,250 mg/m 2 3-weekly). 15.8%). No differences in non-haematologic toxicities in both arms except anorexia were observed. The median survival was 13.4 months for gemcitabine 1,000 mg group compared with 15.8 months for gemcitabine 1,250 mg group. There were no statistically significant differences in survival between the groups. Conclusion: For stage III or IV non-small cell lung cancer, combination chemotherapy with gemcitabine 1,000 mg/m 2 showed equivalent response rate with lesser neutropenia and anorexia compared to treatment with gemcitabine 1,250 mg/m 2 . (J Lung Cancer 2007;6(1):1 7)
Selenium in the form of selenized yeast was reported by Clark et al. to have possible lung cancer chemopreventive benefits based on a secondary observation emanating from a large skin cancer prevention trial. (JAMA 1996; 276: 1957-1963. Since that time, epidemiologic, in vitro, and therapeutic research studies have continued to support the hypothesis that non-toxic selenium supplementation may decrease the risk of aerodigestive cancer in persons at high risk, e.g., those with resected bronchogenic cancer. Since October 2000, the Eastern Cooperative Oncology Group (ECOG) with support from the National Cancer Institute Division of Cancer Prevention (NCI-DCP) has been conducting an intergroup double blind placebo controlled trial using 200 micrograms of Selenium in a 2:1 randomization versus placebo. Eligibility requirements include completely resected Stage I (T1 or T2, N0) non-small cell cancer of the lung with a minimum of 1 negative mediastinal lymph node. Pts must have normal level of selenium / vitamin intake, satisfactory liver function, a negative chest x-ray and no other evidence of recurrence. Enrollment is allowed from 6 to 36 months post thoracotomy. A four wk run-in period is required during which pts must take at least 75% of the study drug to document compliance. As of March 7, 2007, 1268 pts have enrolled out of a projected total study size of 1960 participants. Treatment is for 48 months. Study endpoints include cancer recurrence, incidence of second primary lung tumors (SPTs), and/or toxicity. Treatment appears to be extremely well tolerated in this study. As of December 2006, a total of 363 patients on randomized step have reported treatment-related toxicities. Only six of them reported toxicities of grade 3 or higher as a worst toxicity. 133 grade 3, 4, or 5 severe adverse events have been reported with no difference between study drug and placebo. A total of six cooperative groups are participating in this ambitious project. Selenium appears to be very well tolerated in this setting. Accrual is projected to continue until 1960 pts have enrolled or until 90 SPTs have occurred.
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