A phase II study of weekly high-dose cisplatin combined with oral etoposide in advanced non-small-cell lung cancer

Planting, A. S. T.; Kho, Siang G.; Burg, M. van der; Goey, Hoo; Schellens, Jan H.M.; Bent, Martin J. van den; Gaast, Ate van der; Boer-Dennert, M. de; Stoter, G.; Verweij, Jaap

doi:10.1007/s002800050668

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…In 116 patients (29%), creatinine clearance decreased 25% or more; the median decrease in creatinine clearance was 16%. This certainly does not exceed the nephrotoxicity reported from conventional 3-weekly cisplatin treatment, and confirms previous observations that haematological, and not renal, toxicity is the major dose-limiting adverse event of weekly high-dose cisplatin chemotherapy (Planting et al, 1993(Planting et al, , 1997a. The administration of cisplatin in a solution with hypertonic saline may have alleviated renal toxicity, thus allowing dose-dense cisplatin treatment.…”

Section: Discussionsupporting

confidence: 86%

Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients

et al. 2003

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In the present study we describe the toxicity of weekly high-dose (70 -85 mg m À2 ) cisplatin in 400 patients (203 men, 197 women; median age 54 years) with advanced solid tumours treated in the period 1990 -2001 who took part in phase I/II trials, investigating the feasibility and efficacy of weekly cisplatin alone, or in combination with paclitaxel or etoposide. Cisplatin was administered in 250 ml NaCl 3% over 3 h, for six intended administrations. The mean number of administrations was 5.3 (range, 1 -6 administrations).Reasons not to complete six cycles were disease progression (7.5%), haematological toxicity (9%), nephrotoxicity (7%), ototoxicity (2.5%), neurotoxicity (1%), gastrointestinal toxicity (1%), cardiovascular complications (0.5%) or a combination of reasons including noncompliance and patient's request (5.5%). Logistic regression analysis was used to evaluate baseline parameters for prognostic value regarding toxicity. Leukopenia correlated with etoposide cotreatment, and thrombocytopenia with cisplatin dose and prior (platinum-based) chemotherapy. Risk factors for nephrotoxicity were older age, female gender, smoking, hypoalbuminaemia and paclitaxel coadministration. Neurotoxicity 4grade 1 (11% of patients) was associated with prior chemotherapy and paclitaxel coadministration. Symptomatic hearing loss occurred in 15% with anaemia as the predisposing factor. We conclude that weekly highdose cisplatin administered in hypertonic saline is a feasible treatment regimen.

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Section: Discussionsupporting

confidence: 86%

Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients

et al. 2003

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“…Our current hypothesis is that dose-intensification by shortening dose-intervals might be an approach to overcome clinical drug resistance. We have recently tested this concept in non-small cell lung cancer and ovarian cancer by giving cis-Pt weekly instead of three-weekly and demonstrated increased response rates of up to 52% and 90%, respec- tively [20,21]. In these studies, however, cw-Pt-induced leukocytopenia appeared to be the dose-limiting toxicity.…”

Section: Discussionmentioning

confidence: 99%

Differential modulation of cisplatin accumulation in leukocytes and tumor cell lines by the paclitaxel vehicle Cremophor EL

Vos¹,

Nooter²,

Verweij³

et al. 1997

Annals of Oncology

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SummaryBackground: Several clinical studies have shown that polychemotherapy with the taxanes paclitaxel or docetaxel preceded or followed by cisplatin is associated with important schedule-dependent differences in toxicities, such as leukocytopenia. In general, the pharmacokinetics of both drugs during the combined treatment are unaltered, suggesting that a pharmacodynamic interaction might have occurred.Materials and methods-In order to gain insight into this pharmacologic interaction, we performed in vitro drug accumulation studies using peripheral blood leukocytes and a panel of tumor and non-malignant cell lines with paclitaxel and docetaxel, as wel as with their respective formulation vehicles Cremophor EL and Tween 80.

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“…Weekly cisplatin was proven to be efficacious in diverse tumor types such as NSCLC, 14 head and neck cancer, 15 and ovarian cancer. 16 Its unique renal elimination permits administration in patients with severe jaundice and subsequent poor liver function.…”

Section: Discussionmentioning

confidence: 99%

Weekly cisplatin may reverse liver dysfunction and jaundice caused by diffuse liver metastases of solid tumors

Gabrovska¹,

Geurs²,

Ponette³

et al. 2009

HMER

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Few data are available on patient management in jaundice caused by liver metastases of solid tumors (nonbreast and noncolon origin). We report the first patient series consecutively treated with cisplatin weekly in patients with severe jaundice and liver failure due to underlying metastatic neoplasms. In 4 out of 8 cases, liver function tests were reversed and jaundice disappeared, permitting subsequent standard chemotherapy. The other 4 patients died 3 to 5 weeks after admission, illustrating the extent and severity of the underlying neoplasm.

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A phase II study of weekly high-dose cisplatin combined with oral etoposide in advanced non-small-cell lung cancer

Cited by 10 publications

References 23 publications

Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients

Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients

Differential modulation of cisplatin accumulation in leukocytes and tumor cell lines by the paclitaxel vehicle Cremophor EL

Weekly cisplatin may reverse liver dysfunction and jaundice caused by diffuse liver metastases of solid tumors

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