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Optimized sequence of drug administration and schedule leads to improved dose delivery for gemcitabine and paclitaxel in combination: a phase I trial in patients with recurrent ovarian cancer.
Poole, C J; Perren, T; Gawande, S; Ridderheim, M; Cook, J; Jenkins, A; Roychowdhury, D.
Afiliación
  • Poole CJ; CR UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom. c.j.poole@bham.ac.uk
Int J Gynecol Cancer ; 16(2): 507-14, 2006.
Article en En | MEDLINE | ID: mdl-16681719
We examined appropriate sequence, schedule, and doses of gemcitabine (G) and paclitaxel (T) in patients with persistent or recurrent epithelial ovarian cancer. Patients received a maximum of six cycles of gemcitabine on days 1 and 8 (starting 1000 mg/m(2)), and paclitaxel (starting 135 mg/m(2)) on day 8 (groups A and B) or day 1 (group C). Drug sequences (G-->T and T-->G) were tested in group A. In group A, changing sequences of gemcitabine and paclitaxel infusion were evaluated. Sequence G-->T raised grade 3 alanine transaminase in two of three patients leading to use of T-->G sequence for remainder of study. In group B, maximum tolerable dose was reached at gemcitabine 1000 mg/m(2) and paclitaxel 175 mg/m(2). Reducing paclitaxel to 150 mg/m(2) allowed escalation of gemcitabine to 1250 mg/m(2), but neutropenia-related treatment delays occurred. Giving paclitaxel on day 1 (group C) enabled administration of paclitaxel 175 mg/m(2) and gemcitabine 1250 mg/m(2) with minimal dose adjustments. The overall response rate was 41.0%, with 2 complete responses and 14 partial responses in 39 eligible patients. The schedule of paclitaxel 175 mg/m(2) (day 1) and gemcitabine 1250 mg/m(2) (days 1 and 8), with sequence of T-->G, appears most suitable with tolerable toxicity and promising activity.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Protocolos de Quimioterapia Combinada Antineoplásica / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2006 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ováricas / Protocolos de Quimioterapia Combinada Antineoplásica / Recurrencia Local de Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2006 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido