Initial Pulmonary Toxicity Evaluation of Chemoradiotherapy (CRT) Utilizing 74 Gy 3-Dimensional (3-D) Thoracic Radiation in Stage III Non-Small Cell Lung Cancer (NSCLC): A Cancer and Leukemia Group B (CALGB) Randomized Phase II Trial

Blackstock, A. William; Socinski, M.A.; Fitzgerald, T.; Gu, Long; Rosenman, Julian G.; Wang, X.; Bogart, J.A.; Vokes, Everett E.; Green, M.R.

doi:10.1016/j.ijrobp.2005.07.077

Cited by 4 publications

(4 citation statements)

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“…Although limited by the small number of patients, our data suggest that pemetrexed can be administered at systemically active doses in combination with radiotherapy, which is in contrast to several other active agents in NSCLC [e.g., gemcitabine with prominent acute pulmonary toxicity (34)], but similar to cisplatin/etoposide (35).…”

Section: Discussionmentioning

confidence: 90%

A Phase I Study of Pemetrexed, Carboplatin, and Concurrent Radiotherapy in Patients with Locally Advanced or Metastatic Non–Small Cell Lung or Esophageal Cancer

Seiwert¹,

Connell

Mauer³

et al. 2007

Clinical Cancer Research

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Purpose: The primary objective of this phase I study was to determine the maximum tolerated dose for pemetrexed, alone and in combination with carboplatin, with concurrent radiotherapy. Experimental Design: Patients with locally advanced or metastatic non^small cell lung cancer (NSCLC) or esophageal cancer were treated every 21 days for two cycles. Regimen 1 was pemetrexed (200-600 mg/m 2 ); regimen 2 was pemetrexed (500 mg/m 2 ) with escalating carboplatin doses (AUC = 4-6). Both regimens included concurrent radiation (40-66 Gy; palliative-intent doses were lower). Results: Thirty patients (18 locally advanced and 12 metastatic with dominant local symptoms) were enrolled, with an Eastern Cooperative Oncology Group performance status of 0/1/2 (n = 8/21/1). All dose levels were tolerable for regimen 1 (n = 18: 15 NSCLC and 3 esophageal cancers) and regimen 2 (n = 12: all NSCLC). In regimen 1, one dose-limiting toxicity (grade 4 esophagitis/anorexia) occurred (500 mg/m 2 ). Grade 3 neutropenia (3 of 18 patients) was the main hematologic toxicity. In regimen 2, one dose-limiting toxicity (grade 3 esophagitis) occurred (500 mg/m 2 ; AUC = 6); grade 3/4 leukopenia (4 of12 patients) was the mainhematologic toxicity. Four complete responses (2 pathology proven) and eight partial responses were observed.When systemically active chemotherapy doses were reached, further dose escalation was discontinued, and a phase IIdose-range was established (pemetrexed 500 mg/m 2 and carboplatin AUC = 5-6). Conclusions: The combination of pemetrexed (500 mg/m 2 ) and carboplatin (AUC = 5 or 6) with concurrent radiation is well tolerated, allows for the administration of systemically active chemotherapy doses, and shows signs of activity. To further determine efficacy, safety profile, and optimal dosing, the Cancer and Leukemia Group B study 30407 is currently evaluating this regimen in patients with unresectable stage III NSCLC.

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Section: Discussionmentioning

confidence: 90%

A Phase I Study of Pemetrexed, Carboplatin, and Concurrent Radiotherapy in Patients with Locally Advanced or Metastatic Non–Small Cell Lung or Esophageal Cancer

Seiwert¹,

Connell

Mauer³

et al. 2007

Clinical Cancer Research

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“…Full-dose gemcitabine-based combinations have been studied in the induction setting in several trials. The majority of published data is with gemcitabine and cisplatin [14,[19][20][21][22], although there are also published studies of gemcitabine and carboplatin [23][24][25][26][27][28], vinorelbine [29], and triplet therapy with paclitaxel and a platinum agent [30][31][32]. Most studies used two to three cycles of induction.…”

Section: Gemcitabine Given Sequentially After Radiationmentioning

confidence: 99%

“…In studies evaluating the combination of gemcitabine and carboplatin administered before radiation therapy [23][24][25][26][27][28], the gemcitabine doses have ranged from 1000 to 1250 mg/m 2 on days 1 and 8 with the carboplatin dose ranging from AUC of 5.0 to 5.2 on day 1 every 21 days. Response rates ranged from 30% to 65%, which were similar to those in the gemcitabine with cisplatin studies.…”

Section: Gemcitabine Given Sequentially After Radiationmentioning

confidence: 99%

Gemcitabine and radiation therapy in non-small cell lung cancer: state of the art

Mornex

Girard

2006

Annals of Oncology

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Stage III non-small cell lung cancer (NSCLC) treatment is evolving. There are several choices available regarding which chemotherapy to use and how to optimally combine them with radiotherapy. Gemcitabine (Gemzar, Eli Lilly and Company, Indianapolis, USA) is a chemotherapeutic agent with activity in NSCLC, and preclinical studies have shown that gemcitabine is a potent radiosensitizer. These two characteristics make gemcitabine a potential option when treating patients with stage III NSCLC. This review article describes the efficacy and tolerance of gemcitabine when combined with radiation in those patients. Gemcitabine used concurrently with radiation, as an induction regimen before radiation, and as a consolidation regimen after radiation is reviewed.

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“…18 Higher values of V20 have been correlated with increased risk of pneumonitis. 26,27 Recently, Socinski et al reported a phase I trial that included induction chemotherapy (carboplatin, irinotecan, and paclitaxel) followed by concurrent chemotherapy (carboplatin and paclitaxel) and RT. 28 The RT used in this study contrasted with the other three-dimensional dose escalation trials because it included prophylactic nodal RT during the initial weeks of RT.…”

Section: Three-dimensional Treatment Planning and Dose Escalationmentioning

confidence: 99%

Innovations in the Radiotherapy of Non–Small Cell Lung Cancer

Schild

Bogart

2006

Journal of Thoracic Oncology

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Background: This review was performed to describe recent innovations in the radiation therapy of lung cancer. Methods: The literature was reviewed regarding recent research in the therapy of lung cancer. Emphasis was placed on newer radiation therapy (RT) techniques. Results: Advances in physics and computer technology have improved radiation delivery systems. New strategies have been used, such as altered fractionation patterns, three-dimensional treatment planning, intensity-modulated RT (IMRT), tomotherapy, stereotactic RT, and heavy ion RT. New technologies will make it possible to administer higher doses more precisely, which should result in better disease control, with less toxicity. Conclusion: Further research will improve the outcome of patients with lung cancer by providing more effective tools for the RT of this disease.

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Initial Pulmonary Toxicity Evaluation of Chemoradiotherapy (CRT) Utilizing 74 Gy 3-Dimensional (3-D) Thoracic Radiation in Stage III Non-Small Cell Lung Cancer (NSCLC): A Cancer and Leukemia Group B (CALGB) Randomized Phase II Trial

Cited by 4 publications

References 0 publications

A Phase I Study of Pemetrexed, Carboplatin, and Concurrent Radiotherapy in Patients with Locally Advanced or Metastatic Non–Small Cell Lung or Esophageal Cancer

A Phase I Study of Pemetrexed, Carboplatin, and Concurrent Radiotherapy in Patients with Locally Advanced or Metastatic Non–Small Cell Lung or Esophageal Cancer

Gemcitabine and radiation therapy in non-small cell lung cancer: state of the art

Innovations in the Radiotherapy of Non–Small Cell Lung Cancer

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