CODE chemotherapy with and without granulocyte colony-stimulating factor in small-cell lung cancer

Fukuoka, Masahiro; Masuda, Noriyuki; Negoro, Shunichi; Matsui, Kiyoo; Yana, Takashi; Kudoh, Shinzoh; Kusunoki, Yoko; Takada, Minoru; Kawahara, Masami; Ogawara, Mitsumasa; Kodama, Nobuhiro; Kubota, K.; Furuse, Kiyoyuki

doi:10.1038/bjc.1997.50

Cited by 46 publications

(15 citation statements)

References 16 publications

(6 reference statements)

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“…Dose-dense chemotherapy with the CODE combination (CDDP -VCR -ADM -ETP) and addition of granulocyte colonystimulating factor (G-CSF) can be safely administered to patients with advanced lung cancer (Murray et al, 1991;Fukuoka et al, 1997). Theoretically, this approach might be suitable for chemosensitive tumours such as small-cell lung cancer and thymoma Coldman, 1983, 1984;Levin and Hryniuk, 1987;Murray, 1987).…”

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confidence: 99%

“…Theoretically, this approach might be suitable for chemosensitive tumours such as small-cell lung cancer and thymoma Coldman, 1983, 1984;Levin and Hryniuk, 1987;Murray, 1987). Because some pilot data in Japan suggested that administration of 12 weeks of the CODE chemotherapy was barely feasible, subsequent Japanese trials used a modified schedule, which was shortened to 9 weeks (Fukuoka et al, 1997;Furuse et al, 1998).…”

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A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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BACKGROUND: To evaluate the safety and efficacy of dose-dense weekly chemotherapy in the treatment of advanced thymoma. METHODS: Subjects comprised patients with histologically documented chemotherapy-naïve thymoma with stage-IVa or IVb disease. Thymic carcinoma, carcinoid or lymphoma cases were excluded. Patients received 9 weeks of chemotherapy: cisplatin (25 mg m À2 ) on weeks 1 -9; vincristine (1 mg m À2 ) on weeks 1, 2, 4, 6 and 8; and doxorubicin (40 mg m À2 ) and etoposide (80 mg m À2 ) on days 1 -3 of weeks 1, 3, 5, 7 and 9. Chemotherapy courses were supported by granulocyte colony-stimulating factor. Post-protocol local therapy was allowed. RESULTS: From July 1997 to March 2004, 30 patients were entered. Three were ineligible due to different histology. Chemotherapyassociated toxicity was mainly haematological and was well tolerated, with no deaths due to toxicity, and 87% of patients completed the planned 9-week regimen. Overall response rate was 59%, with 16 of the 27 eligible patients achieving partial response. Median progression-fee survival (PFS) was 0.79 years (95% confidence interval: 0.52 -1.40 years), and PFS at 1 and 2 years was 37 and 15%, respectively. Overall survival rates at 2 and 5 years were 89 and 65%, respectively. CONCLUSION: In stage-IV thymoma patients, weekly dose-dense chemotherapy offers similar activity to conventional regimens.

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A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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“…Fukuoka et al [13] conducted a trial with weekly chemotherapy. Sixty-three patients with ED were randomized to cyclophosphamide, vincristine, doxorubicin, and etoposide (CODE) alone or with G-CSF.…”

Section: Densification Of Chemotherapymentioning

confidence: 99%

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

et al. 2007

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The hypothesis that increasing cytotoxic dose intensity will improve cancer cure rates is compelling. Although supporting evidence for this hypothesis has accrued for several tumor types, including lymphomas, breast cancer, and testicular cancers, it remains unproven. Smallcell lung cancer is extremely chemo-and radiosensitive, with a response rate of 80% achieved routinely, but few patients are cured by chemoradiotherapy. In this setting, increased cytotoxic dose intensity might improve cure rates. The finding that response rates in small-cell lung cancer correlate with received cytotoxic dose intensity merely confirms that "less is worse" and "more is better." Within conventional ranges, dose intensity can be increased with the support of hematopoietic growth factors and/or by shortening treatments intervals; however, dose intensity could be increased by only 20%-30%, and a survival advantage has not been clearly demonstrated. Given its high chemosensitivity, smallcell lung cancer was one of the first malignancies deemed suitable for increasing dose intensity and even for the use of a megadose with the support of autologous bone marrow transplantation. Some interest is emerging again due to improvements in supportive care, such as the availability of hematopoietic growth factors and peripheral blood progenitor cells. The Oncologist 2007; 12:79 -89

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“…[2][3][4][5] Although its mechanism for disposition has been studied extensively in rodents, 6) the establishment of a pharmacokinetic/pharmacodynamic model is needed to predict the pharmacological eŠect of rhG CSF in humans. We developed such a model in our previous study and showed that the model enables prediction of increase in the number of neutrophils after administration of rhG CSF to healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetic/Pharmacodynamic Analysis of Neutrophil Proliferation Induced by rhG-CSF in Patients Receiving Antineoplastic Drugs

et al. 2004

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In the present study, we analyzed the eŠect of recombinant human granulocyte colony stimulating factor (rhG CSF) on neutrophil counts in cancer patients undergoing chemotherapy using a previously developed pharmacokinetic/ pharmacodynamic model. 7) The time proˆles of neutrophil counts in blood after repeated administration of rhG CSF to lung cancer patients undergoing chemotherapy could be analyzed by this model by considering the inhibition of neutrophil production by antineoplastic drugs. Although deviation was observed between the predicted and observed neutrophil counts in ovarian cancer patients, it may be possible to use this model for determining a rational dosage regimen of rhG CSF for patients undergoing chemotherapy.

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CODE chemotherapy with and without granulocyte colony-stimulating factor in small-cell lung cancer

Cited by 46 publications

References 16 publications

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

Pharmacokinetic/Pharmacodynamic Analysis of Neutrophil Proliferation Induced by rhG-CSF in Patients Receiving Antineoplastic Drugs

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