Skip to main content

Advertisement

Log in

Phase I study of the combination of nedaplatin and weekly paclitaxel in patients with advanced non-small cell lung cancer

  • Original Article
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

This trial was conducted to determine the maximum tolerated dose (MTD), principal toxicity, and recommended dose for phase II study of the combination of nedaplatin and weekly paclitaxel in patients with advanced non-small cell lung cancer (NSCLC).

Methods

Patients with previously untreated NSCLC, either stage IIIB with pleural effusion or stage IV, were eligible if they had a performance status of 0–2, were 75 years or younger, and had adequate organ function. The respective doses of nedaplatin (day 1) and weekly paclitaxel (days 1, 8, and 15) studied were 80/60, 80/70, 80/80, 80/90, and 100/90 (mg m−2), repeated every 4 weeks.

Results

From May 2004 through June 2005, 21 patients (18 men and 3 women; median age, 63 years; age range, 53–75 years) were enrolled. The MTD was determined to be 100 mg m−2 of nedaplatin and 90 mg m−2 of weekly paclitaxel. Dose-limiting toxicities at the MTD were neutropenic fever and hepatic dysfunction. We recommend doses of 80 mg m−2 of nedaplatin and 90 mg m−2 of weekly paclitaxel for phase II study. Grade 3–4 hematologic toxicities included neutropenia in 29% of patients, thrombocytopenia in 0%, and anemia in 5%. Although the most frequent non-hematologic toxicity was hepatic dysfunction, all cases were only mildly to moderately severe. Although two patients had grade 3 or 4 pulmonary toxicity due to Pneumocystis carinii pneumonia, these patients recovered after receiving trimetoprim-sulfamethoxazole, steroid therapy, and supplemental oxygen. There were no treatment-related deaths. The overall response rate was 19.0% (95% confidence interval, 5.4–41.9%), and all responses were in patients receiving the recommended doses. The median dose-intensities for nedaplatin and paclitaxel were 91.6 and 87.1%, respectively, of the planned doses.

Conclusion

This combination chemotherapy is active and well tolerated and warrants phase II study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Akerley W, Glantz M, Choy H, Rege V, Sambandam S, Joseph P, Yee L, Rodrigues B, Wingate P, Leone L (1998) Phase I trial of weekly paclitaxel in advanced lung cancer. J Clin Oncol 16:153–158

    PubMed  CAS  Google Scholar 

  2. Belani CP, Barstis J, Perry MC, La Rocca RV, Nattam SR, Rinaldi D, Clark R, Mills GM (2003) Multicenter randomized trial for stage IIIB or IV non-small-cell lung cancer using weekly paclitaxel and carboplatin followed by maintenance weekly paclitaxel or observation. J Clin Oncol 21:2933–2939

    Article  PubMed  CAS  Google Scholar 

  3. Belotti D, Vergani V, Drudis T, Borsotti P, Pitelli MR, Viale G, Giavazzi R, Taraboletti G (1996) The microtubule-affecting drug paclitaxel has antiangiogenic activity. Clin Cancer Res 2:1843–1849

    PubMed  CAS  Google Scholar 

  4. Bookman MA, Kloth DD, Kover PE, Smolinski S, Ozols RF (1997) Short-course intravenous prophylaxis for paclitaxel-related hypersensitivity reactions. Ann Oncol 8:611–614

    Article  PubMed  CAS  Google Scholar 

  5. Furuse K, Fukuoka M, Asamoto H, Niitani H, Kimura I, Sakuma A, Yamaguchi Y (1992) A randomized comparative study of 254-S plus Vindesin (VDS) versus Cisplatin plus VDS in patients with advanced non-small cell lung cancer. Jpn J Cancer Chemothr 19:1019–1026 (in Japanese)

    CAS  Google Scholar 

  6. Georgiadis MS, Russell EK, Gazdar AF, Johnson BE (1997) Paclitaxel cytotoxicity against human lung cancer cell lines increases with prolonged exposure durations. Clin Cancer Res 3:449–454

    PubMed  CAS  Google Scholar 

  7. Kelly K, Crowley J, Burn PA Jr, Presant CA, Grevstad PK, Moinpour CM, Ramsey SD, Wozniak AJ, Weiss GR, Moore DF, Israel VK, Livingston RB, Gandara DR (2001) Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patient with advanced non-small-cell lung cancer: a southwest oncology group trial. J Clin Oncol 19:3210–3218

    PubMed  CAS  Google Scholar 

  8. Klastersky J, Sculier JP, Lacroix H, Dabouis G, Bureau G, Libert P, Richez M, Ravez P, Vandermoten G, Thiriaux J (1990) A randomized study comparing cisplatin or carboplatin with etoposide in patients with advanced non-small-cell lung cancer: European Organization for Research and Treatment of Cancer Protocol 07861. J Clin Oncol 8:1556–1562

    PubMed  CAS  Google Scholar 

  9. Koizumi T, Kubo K, Shinozaki S, Koyama S, Amari T, Hayano T, Fujimoto K, Kobayashi T, Sekiguchi M, Sakai R (1993) Pharmacokinetic evaluation of (glycolao-O,O′) diammine platinum (II) in lung lymph in sheep. Jpn J Cancer Res 84:468–473

    PubMed  CAS  Google Scholar 

  10. Koumakis G, Demiri M, Barbounis V, Vassilomanolakis M, Gontikakis E, Pamouksoglou P, Dahabre J, Efremidis AP (2002) Is weekly paclitaxel superior to paclitaxel given every 3 weeks? Results of phase II trial. Lung Cancer 35:315–317

    Article  PubMed  Google Scholar 

  11. Lau D, Leigh B, Gandara D, Edelman M, Morgan R, Israel V, Lara P, Wilder R, Ryu J, Doroshow J (2001) Twice-weekly paclitaxel and weekly carboplatin with concurrent thoracic radiation followed by carboplatin/paclitaxel consolidation for stage III non-small-cell lung cancer: a California cancer consortium phase II trial. J Clin Oncol 19:442–447

    PubMed  CAS  Google Scholar 

  12. Lau D, Ryu J, Gandara D, Morgan R, Doroshow J, Wilder R, Leigh B (1999) Concurrent twice-weekly paclitaxel and thoracic irradiation for stage III non-small cell lung cancer. Semin Radiat Oncol 9:117–120

    PubMed  CAS  Google Scholar 

  13. Liebmann JE, Cook JA, Lipschultz C, Teague D, Fisher J, Mitchell JB (1993) Cytotoxic studies of paclitaxel (Taxol) in human tumor cell lines. Br J Cancer 68:1104–1109

    PubMed  CAS  Google Scholar 

  14. Oshita F, Yamada K, Kato Y, Ikehara M, Noda K, Tanaka G, Nomura I, Suzuki R, Saito H (2003) Phase I/II study of escalating doses of nedaplatin in combination with irinotecan for advanced non-small cell lung cancer. Cancer Chemother Pharmacol 52:73–78

    Article  PubMed  CAS  Google Scholar 

  15. Ranson M, Davidson N, Nicolson M, Falk S, Carmichael J, Lopez P, Anderson H, Gustafson N, Jeynes A, Gallant G, Washington T, Thatcher N (2000) Randomized trial of paclitaxel plus supportive care versus supportive care for patients with advanced non-small-cell lung cancer. J Natl Cancer Inst 92:1074–1080

    Article  PubMed  CAS  Google Scholar 

  16. Reckzeh B, Merte H, Pfluger KH, Pfab R, Wolf M, Havemann K (1996) Severe lymphocytopenia and interstitial pneumonia in patients treated with paclitaxel and simultaneous radiotherapy for non-small-cell lung cancer. J Clin Oncol 14:1071–1076

    PubMed  CAS  Google Scholar 

  17. Reshkin SJ, Bellizzi A, Cardone RA, Tommasino M, Casavola V, Paradiso A (2003) Paclitaxel induces apoptosis via protein kinase A- and p38 mitogen-activated protein-dependent inhibition of the Na(+)/H(+) exchanger (NHE) isoform 1 in human breast cancer cells. Clin Cancer Res 9:2366–2373

    PubMed  CAS  Google Scholar 

  18. Sandler A, Gray R, Perry M, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH (2006) Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. NEJM 355:2542–2550

    Article  PubMed  CAS  Google Scholar 

  19. Sasaki Y, Saijo N, Tamura T (1987) Comparison of the antitumor activity of cisplatin and its derivatives with special stress on the pharmacokinetics of active form of drugs in the plasma determined by colony assay. Proc Am Soc Clin Oncol 6:34

    Google Scholar 

  20. Shirai T, Hirose T, Noda M, Ando K, Ishida H, Hosaka T, Ozawa T, Okuda K, Ohnishi T, Ohmori T, Horichi N, Adachi M (2006) Phase II study of the combination of gemcitabine and nedaplatin for advanced non-small cell lung cancer. Lung Cancer 52:181–187

    Article  PubMed  Google Scholar 

  21. Schuette W, Blankenburg T, Guschall W, Dittrich I, Schroeder M, Schweisfurth H, Chemaissani A, Schumann C, Dickgreber N, Appel T, Ukena D (2006) Muliticenter randomized trial for stage IIIB/IV non-small-cell lung cancer using every 3-week versus weekly paclitaxel/ carboplatin. Clin Lung Cancer 7:338–343

    Article  PubMed  CAS  Google Scholar 

  22. Seidman AD, Hudis CA, Albanel J, Tong W, Tepler I, Currie V, Moynahan ME, Theodoulou M, Gollub M, Baselga J, Norton L (1998) Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer. J Clin Oncol 16:3353–3361

    PubMed  CAS  Google Scholar 

  23. Sekine I, Nokihara H, Horiike A, Yamamoto N, Kunitoh H, Ohe Y, Tamura T, Kodama T, Saijo N (2004) Phase I study of cisplatin analogue nedaplatin (254-S) and paclitaxel in patients with unresectable squamous cell carcinoma. Br J Cancer 90:1152–1158

    Article  CAS  Google Scholar 

  24. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, Zhu J, Johnson DH (2002) Eastern Cooperative Oncology Group Comparison of four chemotherapy regimens for advanced non-small-cell cancer. N Engl J Med 346:92–98

    Article  PubMed  CAS  Google Scholar 

  25. Shiratori O, Kanai H, Uchida N (1985) (eds) Recent advances in chemotherapy: antitumor activity of 254-S, a platinum complex, in rodents. University of Tokyo Press, Tokyo

  26. Socinski MA, Ivanova A, Bakri K, Wall J, Baggstrom MQ, Hensing TA, Mears A, Tynan M, Beaumont J, Peterman H, Niell HB (2006) A randomized phase II trial comparing every 3-weeks carboplatin/paclitaxel with every 3-weeks carboplatin and weekly paclitaxel in advanced non-small-cell lung cancer. Ann Oncol 17:104–109

    Article  PubMed  CAS  Google Scholar 

  27. Tolaney SM, Partridge AH, Sheib RG, Burstein HJ, Winer EP (2006) Pneumocystis carinii pneumonia during dose-dense chemotherapy for breast cancer. J Clin Oncol 24:5330–5331

    Article  PubMed  Google Scholar 

  28. Yamada H, Uchida N, Maekawa R, Yoshioka T (2001) Sequence-dependent antitumor efficacy of combination chemotherapy with nedaplatin, a newly developed platinum, and paclitaxel. Cancer Lett 172:17–25

    Article  PubMed  CAS  Google Scholar 

  29. Yoshiike F, Koizumi T, Kitaguchi Y Hatayama O, Yasuo M, Sasabayashi M, Wakamatsu H, Fujimoto K, Kubo K (2005) Phase I trial of nedaplatin and paclitaxel for patients with non-small cell lung cancer. J Chemother 17:550–554

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Takashi Hirose.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Okuda, K., Hirose, T., Ishida, H. et al. Phase I study of the combination of nedaplatin and weekly paclitaxel in patients with advanced non-small cell lung cancer. Cancer Chemother Pharmacol 61, 829–835 (2008). https://doi.org/10.1007/s00280-007-0540-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00280-007-0540-6

Keywords

Navigation