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  • 1
    ISSN: 1569-8041
    Keywords: camptothecin analogues ; GG211 ; continuous infusion ; phase I trial ; topoisomerase I inhibitors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Preclinical results support a prolonged schedule of administration for topoisomerase I inhibitors, and we have previously demonstrated the safety and activity of the novel water-soluble topoisomerase I inhibitor GG211 when given as a 72-hour continuous infusion to cancer patients. Patients and methods: In a three-center international phase I trial, 38 patients received GG211 doses from 0.3 to 0.5 mg/m2/day by continuous intravenous infusions for seven, 14, and 21 days. Patients' median performance status was 1; nearly half had colorectal cancer, and 35 patients had prior chemotherapy. Results: The first patient cohort received 0.3 mg/m2/day for seven days with no significant toxicities. Subsequent cohorts received continuous infusions for 14 and 21 days at this dose level with only mild myelosuppression noted. Dose-escalation on the 21-day schedule was then performed. No dose-limiting toxicity occurred at the 0.4 mg/m2/day dose level. Thrombocytopenia was dose-limiting with 0.5 mg/m2/day dosing but was not cumulative. Other grade 3–4 toxicities included neutropenia, nausea, vomiting, diarrhea, and fatigue. Partial responses occurred with 21-day infusion in two patients with breast and ovarian cancer at the 0.3 and 0.4 mg/m2/day dose levels, respectively. Mean GG211 lactone Css ranged from 0.17 to 0.64 ng/ml. Conclusion: The maximum tolerated dose of GG211 administered as a 21-day continuous infusion is 0.4 mg/m2/day with antitumor activity noted at tolerable doses.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: chemotherapy ; gemcitabine ; new drugs ; non-small-cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to determine the clinical activity and toxicity of a novel chemotherapy combination regimen of gemcitabine plus cisplatin, administered every three weeks, in patients with advanced non-small-cell lung cancer (NSCLC). Patients and methods: Twenty-six previously untreated stages III (14) and IV (12) patients were included. Gemcitabine was administered on days 1 and 8 at a dose of 1250 mg/m2 and cisplatin was administered at a dose of 100 mg/m2 on day 1, every 21 days. Results: Twenty-five patients were evaluable for response. One patient achieved a complete response, and 16 patients partial responses. The overall response rate was 65.3% (95% CI: 45%–82%). The main toxicity was hematological: neutropenia NCIC-CTC grade 3–4 in 54% of the patients, and thrombocytopenia grade 3–4 in 23%. The non-hematological toxicity was mild and tolerable. Only 13% of gemcitabine injections were dose-reduced or omitted due to toxicity. The actual dose-intensity of gemcitabine was 715 mg/m2/week, and 31 mg/m2/week for cisplatin. These figures represent the 86% and 93% of the theoretical dose intensity of both drugs, respectively. With a median follow-up of 10 months (range 7–13), 17 patients are still alive and nine have died. The median overall survival is 12 months. Conclusion: This novel combination of gemcitabine and cisplatin administered every three weeks is well tolerated and induces a remarkably high response rate. The regimen proves more interesting than the four-week schedules, particularly regarding patients who are candidates for local therapy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1569-8041
    Keywords: germ cell tumours ; extragonadal ; mediastinum ; cisplatin-based chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Primary mediastinal non-seminomatous germ cell tumours (MNSGCT)constitute a rare malignancy. This study was performed to review ourexperience with cispatin-based chemotherapy in patients with MNSGCT. Patients and methods: Patients with MNSGCT treated with cisplatin-basedcombination chemotherapy between 1978–1995 in three university hospitalsin Spain were retrospectively studied. Results: There were 25 males and two females with a median age of 26 years(range 4–71). Fifteen patients had disease confined to the mediastinumand 12 had metastatic disease. All patients were treated with cisplatinchemotherapy regimens (PVB: 7, BEP: 6, and other regimens 12) and consideredfor residual mass surgery (RMS) when indicated. Eleven patients (40.7%)were rendered disease-free with initial treatment: four with chemotherapyalone, one with surgery plus adjuvant chemotherapy and six with chemotherapyplus RMS. Three of these patients relapsed at two, six and seven months. Theremaining 16 had unfavourable reponses (five partial response, three nochange, seven progressive disease and one toxic death) . Eleven patientsreceived salvage treatment but none of them achieved a durable response. Aftera median follow-up of 77 months (range 1–168), 10 patients remain alive.Actuarial survival at five years is 31.7%. No patients in this seriesdeveloped a haematological malignancy. Chromosomal analysis showed that 2 outof 10 patients (20%) had a 47XXY karyotype. Conclusions: Only patients who achieved disease-free status are likely tobe cured. Therefore, new up-front strategies are needed for the treatment ofMNSGCT.
    Type of Medium: Electronic Resource
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