284 Induction paclitaxel (TAXOL) and carboplatin (CBDCA) followed by concurrent chemoradiotherapy (TRT-CT) in unresectable, locally advanced non-small cell lung carcinoma (NSCLC): Report of FCCC 94-001

Langer, Corey J.; Hudes, Richard; Movsas, Benjamin; Schol, Jessie; Keenan, Eileen; Kilpatrick, Deborah; Yeung, Csy

doi:10.1016/s0169-5002(97)89664-x

Cited by 27 publications

(31 citation statements)

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“…Radiosensitizing effects of both paclitaxel and carboplatin have been described early in the development of these agents [23][24][25]. Promising results regarding toxicity and efficacy have been generated in the setting of concepts including concomitant radiotherapy (RT) in non-small cell lung cancer and other tumors [26][27][28][29]. The present study evaluates the feasibility, toxicity and efficacy of a weekly PC combination schedule in patients with various solid tumors using a shortened infusion duration and prophylactic medication scheme.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Toxicity of Weekly Paclitaxel-Carboplatin in 131 Patients with Pretreated and Non-Pretreated Solid Tumors

D’Addario¹,

Morant²,

Boehme³

et al. 2002

Oncol Res Treat

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Background: Chemotherapy with paclitaxel and carboplatin 3-weekly is active in many tumors. Major toxicities are myelosuppression and neurotoxicity. Weekly administration of taxanes allows high dose intensity with reduced toxicity. Patients and Methods: 131 patients with solid tumors were treated as outpatients with paclitaxel 75 mg/m² and carboplatin AUC 2–3 days 1, 8, 15 every 4 weeks irrespective of pretreatment and partly in neoadjuvant and multimodal concepts. Results: 125 patients (median age 58 years) were evaluable for response and toxicity, of whom 45 suffered esophageal carcinoma (19 patients in neoadjuvant treatment) and 31 non-small cell lung cancer. 49 patients were pretreated. 23 patients received concomitant radiotherapy of esophagus or lung in doses ranging from 40 to 60 Gy. We observed a low hematologic toxicity with 15.2% grade-III/IV leukopenia/granulocytopenia and 3.2% thrombocytopenia grade III/IV. Neurotoxicity grade II was reported in 14 patients. Main toxicity with radiotherapy was esophagitis grade II or III in 7 out of 23 patients. Overall response rate was 54.2%. 5 out of 19 patients treated neoadjuvantly for esophageal cancer reached a pathological complete response. Conclusions: Weekly paclitaxel and carboplatin is safe and feasible in outpatients and a high dose intensity can be achieved. The favorable toxicity profile allows treatment of elderly and pretreated patients. Response rate is high including pathological complete responses and responses appear quickly, making this therapy most suitable for multimodal and neoadjuvant treatments.

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Section: Introductionmentioning

confidence: 99%

Feasibility and Toxicity of Weekly Paclitaxel-Carboplatin in 131 Patients with Pretreated and Non-Pretreated Solid Tumors

D’Addario¹,

Morant²,

Boehme³

et al. 2002

Oncol Res Treat

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“…Paclitaxel has demonstrated promising activity in extensive disease as a single agent with a response of 34-68% (Ettinger et al, 1995;Hainsworth and Greco, 1995) and has shown to act as a radiosensitizer (Kirkbride et al, 1997;Langer et al, 1997;Choy et al, 2000).…”

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confidence: 99%

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Baas

Belderbos

Senan³

et al. 2006

Br J Cancer

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To improve the prognosis of limited stage small cell lung cancer (LS-SCLC) the addition of concurrent thoracic radiotherapy to a platinum-containing regimen is important. In the Netherlands, we initiated a multicenter, phase II study, of the combination of four cycles of carboplatin (AUC 5), paclitaxel (200 mg m À2) and etoposide (2 Â 50 mg orally for 5 days) combined with 45 Gy (daily fractions of 1.8 Gy). The radiation was given to the involved field and concurrently with the second and third chemotherapy cycle. Patients with a partial or complete response received prophylactic cranial irradiation to a dose of 30 Gy. From January 1999 to December 2001, 37 of the 38 patients with LS-SCLC entered were eligible for toxicity analysis and response. Grade 3 and 4 haematological toxicity occurred in 57% (21/37) with febrile neutropenia in 24% (9/37). There were no treatment-related deaths or other grade 4 toxicity. Grade 3 toxicities were oesophagitis (27%), radiation pneumonitis (6%), anorexia (14%), nausea (16%), dyspnea (19%) and lethargy (22%). The objective response rate was 92% (95% confidence interval (CI) 80 -98%) with a median survival time of 19.5 months (95% CI 12.8 -29.2). The 1-, 2-and 5-year survival rate was 70, 47 and 27%, respectively. In field local recurrences occurred in six patients. Distant metastases were observed in 19 patients of which 13 in the brain. This study indicates that combination chemotherapy with concurrent involved-field radiation therapy is an effective treatment for LS-SCLC. Despite PCI, the brain remained the most important site of recurrence.

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“…Severe esophagitis, neutropenic fever, hospital admissions, stump insufficiency, and other serious problems were reported at rates as high as 49% [44][45][46][47][48]. Given these early observations of significant toxicity, more data are needed before routine use of new agents plus RT as induction therapy can be recommended as standard care.…”

Section: Older Versus Newer Chemotherapy Regimens In Induction Programsmentioning

confidence: 99%

Induction chemotherapy or chemoradiotherapy before surgery for non-small-cell lung cancer

Albain

2000

Curr Oncol Rep

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Two controversies regarding the role of induction therapy before surgery in non-small-cell lung cancer are considered through a review of the literature and ongoing trials worldwide. The first debate asks whether surgery is indicated after induction chemotherapy or chemoradiotherapy for patients with advanced stage III disease. The second debate addresses disease presentations with early stage disease or radiographically negative but microscopically positive N2 involvement. The question raised for this group of patients is whether induction chemotherapy with or without radiotherapy should be routinely prescribed before the standard therapy of definitive surgery. For both controversies, data are provocative and in some subsets argue in favor of the more aggressive approach. However, changes in standard-of-care recommendations are premature. Thus, ongoing worldwide trials maintain control arms of chemoradiotherapy alone and of surgery alone in the advanced and early disease subsets, respectively.

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284 Induction paclitaxel (TAXOL) and carboplatin (CBDCA) followed by concurrent chemoradiotherapy (TRT-CT) in unresectable, locally advanced non-small cell lung carcinoma (NSCLC): Report of FCCC 94-001

Cited by 27 publications

References 0 publications

Feasibility and Toxicity of Weekly Paclitaxel-Carboplatin in 131 Patients with Pretreated and Non-Pretreated Solid Tumors

Feasibility and Toxicity of Weekly Paclitaxel-Carboplatin in 131 Patients with Pretreated and Non-Pretreated Solid Tumors

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Induction chemotherapy or chemoradiotherapy before surgery for non-small-cell lung cancer

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