Low-dose Weekly Paclitaxel as Second-line Treatment for Advanced Non-small Cell Lung Cancer: a Phase II Study

Juan, Ó.; Albert, A.; Ordoño, Fermín; Casany, Rosa; Carañana, Vicente; Campos, Juan; Alberola, Vicente

doi:10.1093/jjco/hyf098

Cited by 27 publications

(8 citation statements)

References 23 publications

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“…Response rates with paclitaxel of the range of 0 -38% in previously published studies (Socinski et al, 1999(Socinski et al, , 2002Juan et al, 2002;Sculier et al, 2002a;Buccheri and Ferrigno, 2004;Ceresoli et al, 2004;Yasuda et al, 2004), and of the order of 7.7 and 11.6% in PF and SF patients, respectively, observed in the present study are similar to those with docetaxel, ranging from 2.7 to 12.6% (Fossella et al, 2000;Shepherd et al, 2000;Gridelli et al, 2004;Hanna et al, 2004;Quoix et al, 2004;Gervais et al, 2005;Schuette et al, 2005;Camps et al, 2006).…”

Section: Discussionsupporting

confidence: 87%

“…Similar were MST with paclitaxel in previous studies, ranging from 4.5 to 14 months (Socinski et al, 1999(Socinski et al, , 2002Juan et al, 2002;Sculier et al, 2002a;Buccheri and Ferrigno, 2004;Ceresoli et al, 2004;Yasuda et al, 2004). The equivalence of both drugs was evaluated in one small randomised phase II study only.…”

Section: Discussionmentioning

confidence: 96%

“…Docetaxel, which has been shown to significantly improve survival compared with supportive care only (Shepherd et al, 2000), is currently proposed as second-line chemotherapy in NSCLC patients failing after platinum-based chemotherapy (Socinski et al, 2003;Pfister et al, 2004;European Lung Cancer Working Party, 2006). Paclitaxel, the other available taxane, has also demonstrated potential activity in the same indication in a few phase II studies (Socinski et al, 1999;Juan et al, 2002;Socinski et al, 2002;Sculier et al, 2002a;Buccheri and Ferrigno, 2004;Ceresoli et al, 2004;Yasuda et al, 2004). There is only one randomised phase II study, including 71 patients, which directly compares paclitaxel to docetaxel (Esteban et al, 2003).…”

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Second-line paclitaxel in non-small cell lung cancer initially treated with cisplatin: a study by the European Lung Cancer Working Party

et al. 2007

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In the context of a phase III trial comparing in advanced non-small cell lung cancer (NSCLC) sequential to conventional administration of cisplatin-based chemotherapy and paclitaxel, we evaluated the activity of paclitaxel as second-line chemotherapy and investigated any relation of its efficacy with the type of failure after cisplatin. Patients received three courses of induction GIP (gemcitabine, ifosfamide, cisplatin). Non-progressing patients were randomised between three further courses of GIP or three courses of paclitaxel. Second-line paclitaxel was given to patients with primary failure (PF) to GIP and to those progressing after randomisation to further GIP (secondary failure or SF). One hundred sixty patients received second-line paclitaxel. Response rates were 7.7% for PF and 11.6% for SF (P ¼ 0.42). Median survival times (calculated from paclitaxel start) were 4.1 and 7.1 months for PF and SF (P ¼ 0.002). In multivariate analysis, three variables were independently associated with better survival: SF (hazard ratio (HR) ¼ 1.55, 95% confidence interval (CI) 1.08 -2.22; P ¼ 0.02), normal haemoglobin level (HR ¼ 1.56, 95% CI 1.08 -2.26; P ¼ 0.02) and minimal weight loss (HR ¼ 1.79, 95% CI 1.26 -2.55; P ¼ 0.001). Paclitaxel in NSCLC patients, whether given for primary or for SF after cisplatin-based chemotherapy, demonstrates activity similar to other drugs considered active as second-line therapy.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 96%

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confidence: 99%

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Second-line paclitaxel in non-small cell lung cancer initially treated with cisplatin: a study by the European Lung Cancer Working Party

et al. 2007

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“…Relatively low dose of Tx (10 nM) was used for the understanding of the study because it has been reported that low dose of Tx can show tumour control with lesser toxicity to normal cells. 23,24 Moreover, due to poor vascularisation, various portions of cancer tissue are known to develop resistance phenomenon for low exposure to drugs; therefore, low drug dose is physiologically more significant than higher doses. At early stage, cancer cells showed sensitivity to exposure with low dose Tx (10 nM) and thereafter those gradually became resistant to it over a period of 40 days.…”

Section: Introductionmentioning

confidence: 99%

Paclitaxel resistance development is associated with biphasic changes in reactive oxygen species, mitochondrial membrane potential and autophagy with elevated energy production capacity in lung cancer cells: A chronological study

et al. 2017

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Paclitaxel (Tx) is one of the first-line chemotherapeutic drugs used against lung cancer, but acquired resistance to this drug is a major challenge against successful chemotherapy. In this work, we have focused on the chronological changes of various cellular parameters and associated effect on Tx (10 nM) resistance development in A549 cell line. It was observed, at initial stage, the cell death percentage due to drug treatment had increased up to 20 days, and thereafter, it started declining and became completely resistant by 40 days. Expressions of βIII tubulin and drug efflux pumps also increased over the period of resistance development. Changes in cellular autophagy and reactive oxygen species generation showed a biphasic pattern and increased gradually over the course of upto 20 days, thereafter declined gradually; however, their levels remained higher than untreated cells when resistance was acquired. Increase in extracellular acidification rates and oxygen consumption rates was found to be directly correlated with acquisition of resistance. The depolarisation of mitochondrial membrane potential was also biphasic; first, it increased with increase of cell death up to 20 days, thereafter, it gradually decreased to normal level along with resistance development. Increase in activity of catalase, glutathione peroxidase and glutathione content over these periods may attribute in bringing down the reactive oxygen species levels and normalisation of mitochondrial membrane potential in spite of comparatively higher reactive oxygen species production by the Tx-resistant cells.

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“…Phase II studies [126][127][128][129][130][131][132][133][134][135][136][137][138][139][140][141][142] and a follow-up study of all the patients who received paclitaxel as second-line chemotherapy after a randomised phase III trial [143] have demonstrated the activity of the single agent paclitaxel. The equivalent of docetaxel and pemetrexed was evaluated in one small randomised phase II study which found no statistically significant difference in terms of response rate (14 versus 3%) and median survival (105 versus 184 days) [144].…”

Section: Which Are the Recommended Second-line Regimens?mentioning

confidence: 99%

First- and second-line therapy for advanced nonsmall cell lung cancer

Sculier¹,

Moro-Sibilot²

2009

Eur Respir J

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The objectives for the treatment of advanced nonsmall cell lung cancer are palliative and include improvement of survival, symptom control, quality of life and cost. The level of evidence of these benefits is based on multiple randomised trials and meta-analyses. Cisplatinbased chemotherapy with one of the regimens shown to be effective should be preferred. Carboplatin may be substituted for cisplatin if medical contraindications exist. Nonplatinumbased regimens are indicated as first-line treatment for advanced nonsmall cell lung cancer in patients for whom platinum-based chemotherapy is contraindicated. Single drug chemotherapy may be considered in patients with poor performance status. The choice of the active drugs depends on the patient's medical condition. There is no conclusive evidence that high doses of cisplatin (100-120 mg?m -2 ) provide better results than standard lower doses (50-60 mg?m -2 ) in terms of survival. The optimal duration of chemotherapy is poorly documented in advanced nonsmall cell lung cancer. A minimum of four to six cycles is advised in responding patients. Second-line chemotherapy is now accepted as a standard and should be offered to patients with good performance status and failing platinum-based first-line chemotherapy. Evidence is in favour of docetaxel and in the case of adenocarcinoma and adequate renal function, pemetrexed is recommended.

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Low-dose Weekly Paclitaxel as Second-line Treatment for Advanced Non-small Cell Lung Cancer: a Phase II Study

Abstract: A low-dose weekly paclitaxel regimen had good clinical efficacy with low toxicity in this group of patients with poor prognosis. This regimen increases the therapeutic options available for second-line therapy in NSCLC patients.

Cited by 27 publications

References 23 publications

Second-line paclitaxel in non-small cell lung cancer initially treated with cisplatin: a study by the European Lung Cancer Working Party

Second-line paclitaxel in non-small cell lung cancer initially treated with cisplatin: a study by the European Lung Cancer Working Party

Paclitaxel resistance development is associated with biphasic changes in reactive oxygen species, mitochondrial membrane potential and autophagy with elevated energy production capacity in lung cancer cells: A chronological study

First- and second-line therapy for advanced nonsmall cell lung cancer

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