吉西他滨联合顺铂治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌临床观察

目的:观察吉西他滨联合顺铂治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌的疗效、影响因素和不良反应.方法:采用吉西他滨联合顺铂治疗蒽环类及紫杉类耐药的转移性三阴乳腺癌28例.吉西他滨1000mg/m2静脉滴注, 第1、8天;顺铂80mg/m2,分3天静脉滴注, 第1-3天.化疗以21天为1个周期, 至少应用2个周期.结果: 本组患者治疗有效率为46.4%, 中位疾病进展时间为5.5个月.合并有肝脏转移者化疗效果差.无化疗相关死亡病例, 主要不良反应为骨髓抑制及胃肠道反应,Ⅲ-Ⅳ级白细胞和血小板下降分别为10.4%和7.1%.结论: 吉西他滨联合顺铂方案对蒽环类及紫杉类均耐药的转移性三阴乳腺癌仍有较好的近期疗效,不良反应可耐受,是有效的援救方案.     

吉西他滨联合顺铂二线治疗晚期乳腺癌的临床观察

目的:探讨吉西他滨联合顺铂二线治疗晚期乳腺癌的疗效和不良反应。方法:选择蒽环类和(或)紫杉类化疗后的转移性乳腺癌患者30例,采用吉西他滨1000mg/m2,静脉滴注,第1、8天;顺铂25 mg/m2,静脉滴注,第1-3天,21d为1周期,至少2周期后评价疗效。结果:CR2例(6.7%),PR12例(40.0%),总有效率为46.7%。中位生存期12.8个月,中位TTP 5.6个月。主要不良反应为骨髓抑制及胃肠道反应。结论:吉西他滨联合顺铂二线治疗晚期乳腺癌的近期疗效较好,患者耐受性好,值得临床推广。     

奈达铂治疗晚期非小细胞肺癌临床观察

目的:观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌(NSCLC)的疗效和安全性。方法:60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组(GN组)30例,吉西他滨1000mg/m2,第1、8天,静脉滴注30分钟,奈达铂80mg/m2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组(GP组)30例,吉西他滨1 000mg/m2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果:GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异(P>0.05);GP组胃肠道反应(80%)发生率明显高于GN组(56.7%)(P<0.05);两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显(P>0.05);血小板下降GN组(73.3%)较GP组(66.7%)显著(P>0.05),但无统计学差异。结论:吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。     

吉西他滨联合顺铂治疗三阴性晚期乳腺癌的临床观察

目的:观察吉西他滨联合顺铂方案治疗对蒽环类和紫杉类耐药的晚期三阴性乳腺癌的近期疗效和不良反应。方法:32例对蒽环类和紫杉类耐药的晚期乳腺癌患者,经免疫组化证实ER、PR、HER-2均阴性,给予吉西他滨联合顺铂方案治疗,具体用药为:吉西他滨1000mg/m2静脉滴注,第1、8天;顺铂25mg/m2静脉滴注,第1-3天。21天为1周期,至少2个周期。每周期评价不良反应,每2周期后评价疗效,并随访观察肿瘤进展时间。结果:32例患者均可评价疗效与不良反应,获完全缓解(CR)1例(3.1%),部分缓解(PR)10例 (31.2%),稳定(SD)12例(37.5%),进展(PD)9例(28.1%),总有效率(CR+PR)为34.4%（11/32）;中位疾病进展时间为5.2个月。主要不良反应包括骨髓抑制和胃肠道反应,Ⅲ-Ⅳ级中性粒细胞减少及血小板减少发生率分别为33.3%和19.0%,无化疗相关性死亡。结论:吉西他滨联合顺铂方案对蒽环类和紫杉类耐药的晚期三阴性乳腺癌有较好的近期疗效,不良反应可耐受,安全性好。     

紫杉醇联合奈达铂治疗转移性鼻咽癌的临床观察

目的：评价紫杉醇联合奈达铂方案治疗转移性鼻咽癌的近期临床疗效和不良反应。方法：32例既往接受化疗的转移性鼻咽癌患者,接受紫杉醇150mg/㎡d1,静脉滴注3h;奈达铂80g/㎡,静脉滴注2h,d1。每3周重复,每2周期评价疗效。结果：全组32例中23例获得缓解（71.8%）,其中CR 9例（28.1%）。不良反应主要为骨髓抑制。结论：紫杉醇联合奈达铂方案治疗转移性鼻咽癌患者近期疗效确切,耐受性好。     

紫杉醇联合奈达铂治疗转移性鼻咽癌的临床观察

目的:评价紫杉醇联合奈达铂方案治疗转移性鼻咽癌的近期临床疗效和不良反应。方法:32例既往接受化疗的转移性鼻咽癌患者,接受紫杉醇150mg/㎡d1,静脉滴注3h;奈达铂80g/㎡,静脉滴注2h,d1。每3周重复,每2周期评价疗效。结果:全组32例中23例获得缓解(71.8%),其中CR 9例(28.1%)。不良反应主要为骨髓抑制。结论:紫杉醇联合奈达铂方案治疗转移性鼻咽癌患者近期疗效确切,耐受性好。     

奈达铂治疗晚期非小细胞肺癌临床观察

目的：观察吉西他滨联合奈达铂与联合顺铂方案治疗晚期非小细胞肺癌（NSCLC）的疗效和安全性。方法：60例中晚期非小细胞肺癌患者,其中吉西他滨联合奈达铂化疗方案组（GN组）30例,吉西他滨1000mg/m^2,第1、8天,静脉滴注30分钟,奈达铂80mg/m^2,第2天,滴注时间大于1小时;吉西他滨联合顺铂化疗方案组（GP组）30例,吉西他滨1 000mg/m^2,第1、8天,静脉滴注30分钟,顺铂80-100 mg/m^2,分3d,常规水化利尿。以上2组方案均21天为一个周期。结果：GN组有效率36.67%,GP组有效率40.00%,两组间无显著差异（P〉0.05）;GP组胃肠道反应（80%）发生率明显高于GN组（56.7%）（P〈0.05）;两组肾脏毒性无明显差异;两组白细胞下降发生率分别为56.7%和50.0%,奈达铂组明显（P〉0.05）;血小板下降GN组（73.3%）较GP组（66.7%）显著（P〉0.05）,但无统计学差异。结论：吉西他滨联合奈达铂治疗晚期NSCLC的有效率不低于吉西他滨联合顺铂方案,胃肠道毒性较轻,不良反应主要为骨髓抑制及过敏反应。     

紫杉醇联合顺铂治疗晚期乳腺癌临床观察

目的:观察紫杉醇联合顺铂(TP方案)治疗蒽环类耐药的复发转移性晚期乳腺癌的疗效与安全性.方法:从2005年6月-2008年6月以TP方案治疗蒽环类耐药的复发转移性晚期乳腺癌28例,紫杉醇135mg/m2静滴,第1天;顺铂75mg/m2静滴,第一天,21天为1周期,2个周期末评价近期疗效及安全性.结果:28例患者中CR 1例(3.5%),PR 13例(46.4%),SD 8例(28.5%),PD 6例(21.4%),有效率50%,不良反应主要是骨髓抑制,恶心、呕吐、脱发.结论:TP方案治疗蒽环类耐药的复发转移性晚期乳腺癌疗效可靠,不良反应可耐受,可作为蒽环类耐药的复发转移性晚期乳腺癌的化疗方案.     

铂类为基础的三种化疗方案治疗晚期非小细胞肺癌的临床研究

目的:观察紫杉醇(paclitaxel,Taxel)、长春瑞滨(vinorelbine,NVB)、吉西他滨(gemcitabine,GEM)分别联合顺铂(cisplatin,DDP)方案对晚期非小细胞肺癌(non-small cell lung cancel,NSCLC)的疗效及毒副反应.方法:93例晚期非小细胞肺癌患者随机分为TP组(紫杉醇 顺铂)32例、NP组(长春瑞滨 顺铂)31例、GP组(吉西他滨 顺铂)30例.给药方法:紫杉醇135mg/m2,第1天;长春瑞滨25mg/m2,吉西他滨1000mg/m2,均在第1、8天使用;顺铂80mg/m2,分2天使用.统计各组有效率(CR PR)、中位生存期(medi-an duration of survival)、1年生存率(1 year survival rate).结果:TP组有效率(CR PR)为43.8%,中位生存期为8.6月,1年生存率为32.1%;NP组有效率为38.7%,中位生存期为8.4月,1年生存率为26.5%;GP组有效率为36.7%,中位生存期为9.4月,1年生存率为38.1%,三组问疗效无显著差异(P>0.05).主要不良反应为骨髓抑制、消化道反应,均可耐受.TP组骨髓抑制发生率相对较高,NP组静脉炎发生率高于TP、GP组,有显著性差异(P＜0.05).结论:三种联合化疗方案对晚期NSCLC疗效确切,三种方案间无显著差异,均可作为一线化疗方案在临床应用.     

奈达铂联合吉西他滨治疗晚期非小细胞肺癌的临床研究

目的:观察奈达铂(Nedaplatin,NDP)联合吉西他滨(Gemcitabine,GEM)治疗晚期非小细胞肺癌(NSCLC)的疗效及不良反应。方法:将43例NSCLC病人随机分成试验组和对照组,试验组:NDP100mg/m2,静注,第1天;吉西他滨(GEM)1000mg/m2,静注,第1、8天。对照组:顺铂80~100mg/m2,静注,第1天(联合水化);吉西他滨(GEM)1000mg/m2,静注,第1、8天。两个方案均为每3周1个周期。结果:入组的43例均可评价疗效,试验组24例,PR9例,SD6例,PD9例,有效率(RR)为37.5%(9/24);对照组19例,PR7例,SD7例,PD5例,RR为36.8%(7/19),两组有效率相当(P=0.965)。骨髓抑制是两个方案的主要不良反应。对照组呕吐的发生率明显高于试验组(P=0.004),两组的其他不良反应相近(P>0.05)。试验组住院时间明显短于对照组,而住院费用则高于对照组。结论:奈达铂联合吉西他滨与顺铂联合吉西他滨对晚期NSCLC疗效相当,奈达铂的消化道反应明显低于顺铂,住院时间较短,临床可根据不同病人选择不同方案。     

Gemcitabine Plus Nedaplatin as Salvage Therapy is a Favorable Option for Patients with Progressive Metastatic Urothelial Carcinoma After Two Lines of Chemotherapy

This study was conducted to evaluate the effectiveness of a combination of gemcitabine and nedaplatin therapyamong patients with metastatic urothelial carcinoma previously treated with two lines of chemotherapy. BetweenFebruary 2009 and August 2013, 30 patients were treated with gemcitabine and paclitaxel as a second-linechemotherapy. All had received a first-line chemotherapy consisting of methotrexate, vinblastine, doxorubicinand cisplatin. Ten patients who had measurable histologically proven advanced or metastatic urothelialcarcinoma of the urinary bladder and upper urinary tract received gemcitabine 1,000 mg/m2 on days 1, 8 and15 and nedaplatin 70 mg/m2 on day 2 as a third-line chemotherapy. Tumors were assessed by imaging everytwo cycles. The median number of treatment cycles was 3.5. One patient had partial response and three hadstable disease. The disease-control rate was 40%, the median overall survival was 8.8 months and the medianprogression-free survival was 5.0 months. The median overall survival times for the first-line and second-linetherapies were 29.1 and 13.9 months, respectively. Among disease-controlled patients (n=4), median overallsurvival was 14.2 months. Myelosuppression was the most common toxicity. There were no therapy-relateddeaths. Gemcitabine and nedaplatin chemotherapy is a favorable third-line chemotherapeutic option for patientswith metastatic urothelial carcinoma. Given the safety and benefit profile seen in this study, further prospectivetrials are warranted given the implications of our results with regard to strategic chemotherapy for patientswith advanced or metastatic urothelial carcinoma.     

紫杉醇联合不同铂类治疗晚期食管癌疗效和毒副反应的比较

目的:观察紫杉醇分别联合顺铂、奈达铂治疗晚期食管癌的疗效和毒副反应。方法:收集58例Ⅳ期食管癌患者,分为紫杉醇联合顺铂组（TP）31例和紫杉醇联合奈达铂组（TN）27例,其中紫杉醇注射液135mg/m2,静脉滴注3小时,d1;顺铂25mg/m2,静脉滴注,d1~d3,奈达铂80mg/m2,d1;21天为1个周期。结果:紫杉醇+顺铂组与紫杉醇+奈达铂组有效率分别为37.10%和51.85%（P=0.315）;两组疾病控制率分别为77.42%和81.48%（P=0.703）;两组患者中位无进展生存期分别为6.8和7.8个月（P=0.678）;中位总生存期分别为10.4和11.4个月（P=0.412）,差异均无统计学意义。两组中恶心呕吐、食欲下降两种毒副反应发生率比较,差异有统计学意义（P值分别为0.009和0.007）。结论:紫杉醇联合顺铂或奈达铂治疗晚期食管癌有效率与生存期无统计学差异,但联合奈达铂方案胃肠道毒副反应较轻。     

Paclitaxel, ifosfamide, and nedaplatin as second-line treatment for patients with metastatic urothelial carcinoma: a phase II study of the SUOC group

There is no standard second‐line chemotherapy treatment for recurrent or metastatic urothelial cancer (MUC). The purpose of this phase II study was to evaluate the efficacy and toxicity of the three‐drug combination of paclitaxel, ifosfamide, and nedaplatin (TIN). Patients with MUC were eligible after treatment failure with methotrexate, vinblastine, doxorubicin, and cisplatin, or gemcitabine and cisplatin. Doses for TIN therapy were paclitaxel 175 mg/m² on day 1, ifosfamide 1500 mg/m² on days 1–3, and nedaplatin 70 mg/m² on day 1, every 4 weeks. Tumor response, the primary efficacy parameter, was assessed according to unidimensional measurements (Response Evaluation Criteria in Solid Tumors criteria, version 1.0). Secondary efficacy parameters were overall survival (OS) and progression‐free survival (PFS). Toxicity was assessed according to the National Cancer Institute Common Toxicity Criteria, version 3.0. A total of 45 patients (13 females and 32 males) with MUC were evaluable for response and toxicity. The overall response rate was 40.0%. Median PFS time was 4.0 months (95% confidence interval [CI], 4.6–11.6). Median OS time was 8.9 months (95% CI, 10.5–18.9). Grade 3 or 4 hematologic adverse events were neutropenia (95.6%), anemia (15.6%), and thrombocytopenia (17.8%). The most common grade 3 or 4 non‐hematologic adverse events were anorexia (4.4%) and elevated aspartate transaminase/alanine transaminase (2.2%). No toxic death was observed. The main limitation of this study is that only 10 patients (22.2%) who were previously treated with gemcitabine and cisplatin were included. In conclusion, TIN as second‐line treatment for MUC is an active regimen with a manageable toxicity profile. (Cancer Sci 2011; 102: 1171–1175)     

Paclitaxel, carboplatin, and gemcitabine in metastatic nasopharyngeal carcinoma: a Phase II trial using a triplet combination

BACKGROUND: Patients with nasopharyngeal carcinoma (NPC) are treated primarily with radiotherapy. In the disseminated state, platinum-based, 2-drug combination regimens yielded response rates of 55-75%, achieving a median survival of 10-12 months. With the proven efficacy of second-generation cytotoxics like paclitaxel and gemcitabine in patients with metastatic NPC, the authors hypothesized that a triplet combination incorporating these newer cytotoxics may improve treatment results. METHODS: Thirty-two patients with metastatic NPC were treated with combination chemotherapy that included paclitaxel 70 mg/m(2) on Days 1 and 8, carboplatin dosed to area under curve of 5 on Day 1, and gemcitabine 1000 mg/m(2) on Days 1 and 8 every 21 days for a maximum of 8 cycles. RESULTS: Two patients achieved a complete response, and 23 patients achieved a partial response, for an overall response rate of 78%. The main toxicities were hematologic, with 41% of patients experiencing Grade 3 or 4 anemia, 41% of patients experiencing Grade 3 or 4 thrombocytopenia, and 78% of patients experiencing Grade 3 or 4 neutropenia. The median time to disease progression was 8.1 months, and the median overall survival was 18.6 months. CONCLUSIONS: The combination of paclitaxel, carboplatin, and gemcitabine showed promising efficacy against metastatic NPC but at the expense of considerable toxicity.     

雷那度胺联合GDP方案治疗老年复发难治性T细胞性非霍奇金淋巴瘤的临床疗效

目的:观察雷那度胺联合GDP方案（吉西他滨+顺铂+地塞米松）治疗老年复发难治性T细胞性非霍奇金淋巴瘤（T-NHL）的疗效。方法:收集15例复发难治性T-NHL,给予吉西他滨1 000mg/m2,第1天和第8天;顺铂25mg/m2,第1~3天;地塞米松20mg/m2,第1~5天,21天为1个周期。同时雷那度胺10mg日一次口服,每3周停1周。结果:治疗总有效率73.3%（11/15）,其中完全缓解率33.3%（5/15）,部分缓解率40.0%（6/15）,病情稳定13.3%（2/15）,疾病进展13.3%（2/15）;化疗前后B类症状发生率为73.3%vs 26.7%（P=0.021）。1 年无进展生存率（PFS）为46.7%(7/15),2年PFS为20.0%(3/15),1年总生存率（OS）66.7%（10/15）,2年OS 26.7%(4/15)。不良反应主要为血液学毒性、消化道反应、肝功能损害、皮疹。结论:雷那度胺联合GDP方案是治疗老年复发难治性T-NHL较为安全有效的化疗方案。     

Gemcitabine and cisplatin in advanced nasopharyngeal carcinoma: a pilot study

A pilot study was performed to evaluate the efficacy and safety of gemcitabine and cisplatin combination in the treatment of patients with metastatic nasopharyngeal carcinoma (NPC). Eligible patients were those with metastatic NPC who had been treated with radiotherapy and cisplatin plus 5-fluorouracil chemotherapy. Cisplatin was given intravenously at the fixed dose of 30 mg/m² on days 1-3. Gemcitabine was intravenously administered over 30 min infusion with the dose escalated from 800 to 1200 mg/m² on days 1 and 8. The 3-week schedule defined a cycle of treatment. Fifteen patients were enrolled and assessed for the worst toxicities. For a total of 83 cycles, Grade 3-4 toxicity was 46.7% for neutropenia, 40.0% for thrombocytopenia, and 20.0% for anemia. Grade 3 nonhematologic toxicity was 13.3%. Fourteen patients were assessable for response. The overall response rate was 92.9%, with complete response in three patients (21.4%). Median survival was 10.2 months. Seven patients had lived more than one year, and two patients had lived more than 2 years. The recommended dose of gemcitabine was 1000 mg/m² on days 1 and 8 in each cycle. In conclusion, the present combination is well tolerated and highly active in the treatment of advanced NPC patients.     

Combination phase I study of nedaplatin and gemcitabine for advanced non-small-cell lung cancer

To establish the toxicities and maximum tolerated dose (MTD) of nedaplatin with gemcitabine, and to observe their antitumour activity, we conducted a combination phase I study in advanced non-small-cell lung cancer (NSCLC). Patients received nedaplatin (60-100 mg m(-2) given intravenously over 90 min) on day 1, and gemcitabine (800-1000 mg m(-2) given intravenously over 30 min) on days 1, 8, every 3 weeks. In total, 20 patients with locally advanced or metastatic NSCLC who received no prior chemotherapy or one previous chemotherapy regimen were enrolled. The most frequent toxicities were neutropenia and thrombocytopenia; nonhaematological toxicities were generally mild. Three out of six patients experienced dose-limiting toxicities (neutropenia, thrombocytopenia and delayed anaemia) at dose level 4, 100 mg m(-2) nedaplatin with 1000 mg m(-2) gemcitabine, which was regarded as the MTD. There were three partial responses, for an overall response rate of 16.7%. The median survival time and 1-year survival rate were 9.1 months and 34.1%, respectively. This combination is well tolerated and active for advanced NSCLC. The recommended dose is 80 mg m(-2) nedaplatin with 1000 mg m(-2) gemcitabine. This combination chemotherapy warrants a phase II study and further evaluation in prospective randomised trials with cisplatin- or carboplatin-based combinations as first-line chemotherapy for advanced NSCLC.     

白蛋白结合型紫杉醇联合奈达铂一线治疗晚期食管癌患者的临床观察

背景与目的：化疗是晚期食管癌患者的主要治疗手段,但目前尚没有标准的一线治疗方案,通过白蛋白结合型紫杉醇联合奈达铂方案治疗晚期食管癌,评价其临床疗效及安全性。方法：收集2016年2月—2019年2月之间在长海医院诊治的晚期食管癌并有可评价病灶的患者31例,一线予以白蛋白结合型紫杉醇联合奈达铂方案化疗,具体用药为：白蛋白结合型紫杉醇130 mg/m ² ,第1、8天;奈达铂70 mg/m ² ,第1天;每3周重复。采用实体瘤疗效评价标准（Response Evaluation Criteria in Solid Tumors,RECIST）1.1标准评估疗效,按照美国国立癌症研究所通用毒性标准（National Cancer Institute Common Toxicity Criteria,NCI-CTC）5.0评估不良反应。结果：全部31例患者均可评价疗效,其中完全缓解（complete response,CR）1例（3.2%）,部分缓解（partial response,PR）20例（64.5%）,疾病稳定（stable disease,SD）9例（29.0%）,疾病进展（progressive disease,PD）1例（3.2%）,客观缓解率（objective response rate,ORR）为67.7%,疾病控制率（disease control rate,DCR）为96.8%,中位无进展生存期（progression-free survival,PFS）为9.4个月。常见不良反应主要包括骨髓抑制、感觉神经病变、关节酸痛、肌肉酸痛、消化道反应及脱发,无毒性相关死亡病例。结论：白蛋白结合型紫杉醇联合奈达铂一线治疗晚期食管癌疗效较好,不良反应患者可耐受,值得进一步推广。     

Biweekly paclitaxel and gemcitabine for patients with advanced urothelial cancer ineligible for cisplatin-based regimen

BACKGROUND: To avoid cisplatin-related gastrointestinal, renal and other toxicity while maintaining efficacy in the palliative setting or second line chemotherapeutic regimen for cisplatin-resistant urothelial cancer, chemotherapeutic regimens have been investigated that do not include cisplatin. The current study was designed to evaluate efficacy, clinical feasibility and safety of gemcitabine and paclitaxel (GP) regimen in patients with metastatic urothelial cancer who were ineligible for standard cisplatin-based combination chemotherapy. METHODS: Gemcitabine 2500 mg/m(2) and paclitaxel 150 mg/m(2) were administered intravenously every 2 weeks for 23 patients (17 males and 6 females) with advanced urothelial cancer who were ineligible for cisplatin-based chemotherapy; metastatic disease being resistant to cisplatin-based chemotherapy regimen in 14, heavy toxicity in prior cisplatin-based chemotherapy in three, poor ECOG performance in two and impaired renal function in four. Average age was 67 (53-77). Performance status was 0 in 18 patients, 1 in three patients and 2 in two patients. RESULTS: The overall response rate was 30% (95% CI 15.6-50.8%). Of the 23 patients, no patient attained CR and 7 patients had PR. In the cisplatin-resistant group, the response rate was 14.2% (2/14; 95% CI 4.0-39.9%). In the remaining patients ineligible for cisplatin, the response rate was 55.5% (5/9; 95% CI 26.6-81.1%). The median duration of response was 4 months (range 3-8). The median duration of survival for all patients was 12.1 months (95% CI 8.6-15.5). Myelosuppression, predominantly neutropenia, was the most common serious toxicity and toxicity of Grade 3 or greater was observed in six patients (26%). Among non-hematological toxicity, neuralgia was the most commonly observed and occurred in nine patients (39%) although no patient had toxicity of Grade 3 or greater. Three patients had interstitial pneumonitis possibly attributed to gemcitabine. One patient developed severe bilateral disease after two cycles of the regimen, which was partially resolved with corticosteroid therapy. CONCLUSION: GP regimen is effective in some patients with cisplatin-resistant urothelial cancer and promising as second line chemotherapy. GP regimen is more effective and well tolerated as first line chemotherapy in patients ineligible for cisplatin-based chemotherapy. Toxicity is generally mild but care must be taken for patients with risk of interstitial pneumonitis. A further larger scale study is required to confirm the efficacy of the GP regimen.     

Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal carcinoma

BACKGROUND.: Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS.: Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m(2), paclitaxel at a dose of 70 mg/m(2), and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m(2) and leucovorin at a dose of 30 mg/m(2) for 48 weeks. RESULTS.: Twenty-eight patients were recruited. Twenty-two (79%) patients had >/=2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade 3/4 neutropenia, 32% grade 3/4 anemia, and 29% grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS.: This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival. Cancer 2008. (c) 2008 American Cancer Society.