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  • 1
    Electronic Resource
    Electronic Resource
    Treatment of poor-prognosis extensive disease small-cell lung cancer with an all-oral regimen of etoposide and cyclophosphamide – a Southwest Oncology Group clinical and pharmacokinetic study (1999)
    Springer
    Cancer chemotherapy and pharmacology 44 (1999), S. 461-468 
    Details
    ISSN: 1432-0843
    Keywords: Key words Etoposide ; Cyclophosphamide ; Oral chemotherapy ; Pharmacodynamics ; Small-cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: An all-oral regimen of etoposide and cyclophosphamide was developed for use in poor-prognosis extensive disease small-cell lung cancer. Limited pharmacokinetic sampling was used to derive a pharmacodynamic model predictive of myelosuppression early in the course of therapy. Patients and methods: Eligible patients were chemotherapy-naive and had extensive disease small-cell lung cancer with either SWOG performance status 2 or serum albumin 〈3.5 g/dl. The first cohort (n = 18) received etoposide orally at 50 mg daily and cyclophosphamide orally at 50 mg daily days 1–14 every 28 days. Due to good hematologic tolerance, the second cohort (n = 39) received both agents orally at 50 mg twice daily days 1–14 every 28 days. Plasma etoposide levels were determined in samples drawn at baseline, and at 1 h, 2 h, and 23.5 h (trough) after the first dose. Linear regression analysis was used to determine pharmacokinetic and demographic parameters predictive of myelosuppression. Results: A total of 173 treatment cycles were delivered. Patients on the daily regimen had a 22% response rate (complete and partial), a 22% unconfirmed response rate, and a 5-month median survival, while patients on the twice-daily regimen had a 28% response rate (complete and partial), a 13% unconfirmed response rate, and a 7-month median survival. Granulocytopenia and alopecia were the most common toxicities seen. Significant granulocytopenia could be predicted for the twice-daily regimen according to the formula ln(AGC nadir)=7.80 − 1.88(trough), with an increased incidence of granulocytopenia if the etoposide trough value was ≥1.49 μg/ml. Conclusion: Oral etoposide and oral cyclophosphamide given days 1–14 every 28 days is well tolerated and results in an acceptable response rate and median survival in poor-prognosis (poor performance status or low serum albumin) extensive disease small-cell lung cancer. A trough etoposide level obtained within 24 h of starting therapy can predict severe granulocytopenia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002800051119
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A Phase II Trial of Etoposide, Leucovorin, 5-FU, and Interferon Alpha 2b (ELFI) + G-CSF for Patients with Pancreatic Adenocarcinoma: a Southwest Oncology Group Study (SWOG 9413) (2000)
    Springer
    Investigational new drugs 18 (2000), S. 269-273 
    Details
    ISSN: 1573-0646
    Keywords: combination chemotherapy ; pancreatic cancer ; interferon alpha ; etoposide ; 5-fluorouracil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Background. Chemotherapeutic treatments using combinationsof etoposide, leucovorin and 5-FU (ELF) have shown activity inthe treatment of gastrointestinal malignancies. Interferon alpha2b is known to have antiproliferative effects on several celllines and has well documented in vitro evidence ofsynergism with 5-FU. It was postulated that the combination ofELF and interferon alpha 2b would improve response rates andsurvival in patients with pancreas cancer. Methods. Fifty-five eligible patients with locally-advancedor metastatic pancreatic adenocarcinoma received a regimenconsisting of: IV leucovorin at 300 mg/m2/day on Days 1-3(of 28-day cycle), IV etoposide at 80 mg/m2/day on Days 1-3, IV 5-FU at 500 mg/m2/day on Days 1-3, subcutaneousinterferon alpha 2b at 3 million units TIW, and subcutaneousG-CSF at 5 μg/kg/day on Days 4-14 (or until WBC exceeds10,000/μl). Patients with no evidence of disease progressioncontinued on treatment for a total of 6 cycles. Results. Complete response was demonstrated in 1 patient,partial response in 5 patients (11% confirmed response rate).The median survival was 5 months, and the six-month survival ratewas 40%. Ten patients completed all 6 cycles of treatment.Toxicity-related dose delays and reductions were necessary formost patients. Conclusions. Although the combination of ELF and interferonalpha 2b (ELFI) has modest activity in pancreatic cancer, it isa toxic and complex regimen that is not superior to othercurrently available approaches for the chemotherapeuticmanagement of pancreatic cancer. ELFI cannot be recommended asa standard therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006486025196
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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