Different administration methods of endostar combined with second?line chemotherapy in advanced malignancies

Background: This study aimed to compare the therapeutic efficacy and the side effects of different endostar administration methods in patients with advanced malignancy who underwent second-line chemotherapy. Methods: 98 patients with advanced malignancies were divided into 2 groups based on the delivery methods of endostar, including drip intravenous administration of endostar (DE) group and continuous intravenous administration of endostar (CE) group. Response rate (RR), disease control rate (DCR), and quality of life (QOL) of the patients were examined to evaluate the therapeutic efficacy, and toxicity reactions were analyzed to evaluate the adverse effects. Results: Compared with the DE group, the therapeutic efficacy of CE has been slightly improved, but the difference did not reach statistical significance (P > 0.05). Additionally, no different incidence rate was observed in toxic reactions, including leukopenia, thrombocytopenia, nausea and vomiting, diarrhea, and hepatic function damage, between the DE and CE groups (P > 0.05). Conclusion: In conclusion, no significant difference was observed between the traditional intravenous drip of endostar group and the intravenous drip followed by continuous pumping of endostar group in the patients with advanced malignancies.

Post-progression survival is strongly linked to overall survival in refractory small-cell lung cancer patients who received amrubicin

Background: The benefits of second-line chemotherapy on the overall survival (OS) of small-cell lung cancer (SCLC) patients might be confounded by subsequent therapies. In this study, we aimed to determine the influence of progression-free survival (PFS) and postprogression survival (PPS) on OS after second-line chemotherapy in patients with refractory SCLC treated with amrubicin monotherapy. Materials and Methods: We analyzed the data of 35 patients with refractory SCLC who were treated with amrubicin monotherapy as second-line chemotherapy between July 2005 and December 2015. The correlations of PFS and PPS with OS were statistically analyzed at the individual level using Spearman's rank correlation and linear regression analyses. Results: The correlation between PPS and OS was strong (r = 0.88, P < 0.05, R2 = 0.87), while that between PFS and OS was weak (r = 0.60, P < 0.05, R2 = 0.15). The number of regimens administered after disease progression postsecond-line chemotherapy was significantly associated with PPS (P = 0.003). Conclusions:OS is more strongly linked to PPS than to PFS in refractory SCLC patients who undergo amrubicin monotherapy as a second-line treatment. These results suggest that treatments administered after second-line chemotherapy affect the OS of refractory SCLC patients treated with amrubicin monotherapy

Efficacy and safety of second-line chemotherapy with EOX and FOLFIRI in advanced gastric cancer / 西安交通大学学报(医学版)

Objective To study the clinical efficacy and safety of the regimen of oxaliplatin plus epirubicin and capecitabine (EOX)as the second-line treatment for advanced gastric cancer.Methods We randomly divided 107 patients with advanced gastric cancer for treatment between January 1,2010 and June 1,2013 in our hospital after DCF chemotherapy failed into EOX group (n=56)and FOLFIRI group (n=51).We observed the response rate (RR),disease control rate (DCR),time to progression (PFS),overall survival (OS)and adverse reactions in the two groups.Results RR in EXO group and FOLFIRI group was 28.57% and 25.49%,respectively,without significant difference (P＞0.05).DCR in EXO group and FOLFIRI group was 73.21% and 66.67%,without significant difference (P＞0.05).The median progression-free time (mPFS)in EOX group and FOLFIRI group was 7.4 months and 8.1 months (χ2=0.547,P=0.460),and the median overall survival (mOS)was 19.3 months and 18.5 months (χ2=1.886,P=0.170).The mainly side effects associated with the regimen were leukopenia, thrombocytopenia, anemia, nausea/vomiting, hand-foot syndrome, stomatitis, and peripheral neurotoxicity. Neutropenia,thrombocytopenia,anemia,and diarrhea in EOX group were more frequent than those in FOLFIRI group (P＜0.05).Conclusion The regimen based on EOX is effective in patients with advanced gastric cancer after DCF chemotherapy failed and the toxicities are tolerable.

Observation the clinical efficacy of Apatinib combined with the second line chemotherapy in advanced gas-tric cancer with positive AFP / 实用医学杂志

Objective To investigate the difference of clinical curative effect of Apatinib combined with second line chemotherapy between AFP positive gastric cancer and AFP negative gastric cancer.Methods The da-ta of 78 patients that met the inclusion criteria with advanced gastric cancer from January 2015 to June 2017 were collected from the Second Affiliated Hospital of Zhengzhou University.According to the blood serum AFP levels be-fore treatment(including chemotherapy,surgery)the patients were divided into the AFP positive group(AFPGC) and the AFP negative group(NAFPGC),excluding the impact of other factors.Analysing the difference of the clin-ical effect with apatinib combined with second line chemotherapy in the two groups. Results Getting rid of other factors that may affect the efficacy of chemotherapy,we administered apatinib combined with docetaxel or irinote-can regimen as second line therapy for gastric cancer.The AFP positive group was treated for 2 cycles,4 cycles,in which ORR and DCR were significantly better than that of the AFP negative group(P<0.05).The OS of the AFP positive group and the AFP negative group was 5.5 months,6 months(P = 0.747). No significant adverse reac-tions occurred in the two groups. Conclusion Chemotherapy curative effect of the AFP positive group of apatinib combined with docetaxel or irinotecan is obviously better than that of the AFP negative group in short term,but no obvious difference in long term effect.

Clinical research of drug-resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay for guiding the second-line chemotherapy of lung squamous cell cancer / 肿瘤研究与临床

Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.

Dose escalation of lobaplatin combined with ifxed docetaxel in second-line chemotherapy with solid tumors / 中国癌症杂志

Background and purpose: Malignant tumors often relapsed or metastasized after first-line chemotherapy and needed second-line or above treatment. We conducted this study to deifne the maximum-tolerated dose (MTD) of lobaplatin with ifxed docetaxel for Chinese patients in previously treated solid tumors. Methods:Escalating doses of lobaplatin with fixed docetaxel were administered in a modified Fibonacci sequence. The initial doses were lobapla-tin 30 mg/m2 and docetaxel 60 mg/m2, respectively. Escalating doses was 5 mg/m2. The regimen was repeated every 21 days. If no dose-limiting toxicity (DLT) was observed, the next dose level was applied. The procedures were repeated until DLT appeared. The MTD was declared to be one dose level below the level at which DLT appeared. Results:Seventeen patients received fifty-eight cycles chemotherapy at lobaplatin of levelⅠ(30mg/m2), levelⅡ(35 mg/m2)and levelⅢ(40 mg/m2). Cases of complete response (CR), partial response (PR), stable disease (SD) and progression disease (PD) for the whole group were 0, 1, 10 and 3, respectively. Response rate (RR, CR+PR) and disease control rate (DCR, CR+PR+SD) were 7.1%(1/14) and 78.6%(11/14), respectively. The most common toxicity was leukopenia. Three DLTs occurred in 3 patients in the whole group, including 2 DLTs in dose levelⅢ. We declared thus levelⅡwas MTD. Conclusion:MTD of lobaplatin in our re-search was 35 mg/m2 combined with fixed dose of docetaxel. This combination regimen was well tolerated.

Results of a Phase II Study to Evaluate the Efficacy of Docetaxel and Carboplatin in Metastatic Malignant Melanoma Patients Who Failed First-Line Therapy Containing Dacarbazine / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: There is no standard second-line regimen for malignant melanoma patients with disease progression after first-line chemotherapy, and platinum-alkylating agents combined with paclitaxel have shown modest efficacy. MATERIALS AND METHODS: We conducted a phase II, open-label, single-arm study to test the efficacy of docetaxel combined with carboplatin for malignant melanoma patients who failed previous treatment with dacarbazine. Intravenous docetaxel (35 mg/m2 on days 1 and 8 of each cycle) and carboplatin (area under the curve 3 on days 1 and 8 of each cycle) was administered every 21 days. Primary end point was objective response rate (ORR). RESULTS: Thirty patients were enrolled in the study, and the median follow-up duration was 19.8 months. Among 25 per-protocol patients, there were three responders (1 with complete response and 2 with partial response) and 17 stable disease patients (ORR, 12.0%). Among the per-protocol population, the median progression-free survival (PFS) was 4.3 months and the median overall survival (OS) was 9.6 months. Uveal melanoma patients (n=9) showed the best prognosis compared to other subtypes (median PFS, 7.6 months; OS, 9.9 months). The most common grade 3 or 4 adverse event was neutropenia (n=15, 50.0%). CONCLUSION: Docetaxel combined with carboplatin showed association with an acceptable safety profile and overall efficacy for patients with malignant melanoma who had progressed on chemotherapy containing dacarbazine.

Efficacy and Safety of FOLFIRI after Failure of FOLFOX-4 in Advanced Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: The purpose of this study was to investigate the efficacy and safety of irinotecan based FOLFIRI chemotherapy as a second-line treatment after failure of FOLFOX-4 chemotherapy in patients with advanced gastric cancer. METHODS: Fifty-two patients who were pathologically diagnosed with unresectable gastric cancer and received FOLFIRI chemotherapy after failure of FOLFOX-4 chemotherapy between September 2005 and February 2012 were enrolled in this study. Data were collected by retrospectively reviewing the medical records. The response to chemotherapy was assessed every 3 cycles by World Health Organization criteria and long term survival was analyzed. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institution (NCI) toxicity criteria version 3.0. RESULTS: Median age of the patients was 57 years. Median overall survival (OS) and time to progression (TTP) were 7.8 and 5 months, respectively. The number of patients showing complete remission, partial remission, stable disease, and progressive disease were 0 (0.0%), 9 (17.3%), 30 (57.7%), and 13 (25.0%), respectively. The overall response rate was 17.3%. During a total of 345 cycles, anemia worse than NCI toxicity grade 3 occurred in 2.9%, leukopenia in 20.3%, neutropenia in 12.2%, and thrombocytopenia in 1.5%. Patients with less organ involvement by metastasis, less than 34 U/mL of CA 19-9 and good responsiveness to third cycle of second line chemotherapy were associated with longer OS and TTP. CONCLUSIONS: FOLFIRI chemotherapy has a modest efficacy with acceptable toxicities in patients with advanced gastric cancer as a second-line treatment. Further well-controlled studies are needed to elucidate the efficacy of FOLFIRI chemotherapy as second-line treatment in patients with advanced stomach cancer.

Efficacy comparison on treating advanced non-small-cell lung cancer between using weekly docetaxel and using docetaxel associated with nedaplatin / 肿瘤研究与临床

Objective To compare the efficacy,toxicity and prognosis on treating advanced non-small-cell lung cancer (NSCLC) between using weekly docetaxel (DOC) and using DOC associated with nedaplatin(NDP).Methods 56 cases of NSCLC patients were retrospectively analyzed.Group A included 34 cases who were treated with weekly DOC (35 mg/m2,dl,8).Group B included 22 cases who were treated with DOC associated with NDP (DOC 35 mg/m2,dl,8,NDP 80 mg/m2,d2).One treatment cycle was 21 days.Efficacy,toxicity and prognosis were evaluated after 2 treatment cycles.Results RR of group A was 8.8 ％ (3/34).RR of group B was 27.3 ％ (6/22).DCR of group A was 50.0 ％ (17/34).DCR of group B was 63.6 ％ (14/22).PFS of group A was 2.3 months.PFS of group B was 5.1 months.OS of group A was 8.7 months.OS of group B was 10.5 months.1-year survival rate of group A was 26.5 ％.1-year survival rate of group B was 31.8 ％.The above comparisons were not statistically different (all P ＞ 0.05).In adverse reactions,hematologic toxicity in group B was greater than that in group A (x2 =4.877,P =0.027).Other adverse reactions such as gastrointestinal reactions,fatigue and so on were grade Ⅰ-Ⅱ.Conclusions The treatment of weekly DOC used in advanced NSCLC is safe,effective an low toxicity.There are no significant difference of RR and PFS between single DOC and DOC associated with NDP.

Analysis of efficacy and survival of patients receiving second-line treatment for sensitive recurrent small-cell lung cancer / 肿瘤

Objective: This study is aimed to retrospectively evaluate and compare the efficacy and safety among topotecan, platinum-based rechallenge and other single agent therapies as secondline chemotherapy in patients with sensitive recurrent SCLC (small-cell lung cancer). Methods: Eightythree patients with sensitive recurrent SCLC were recruited in this study and their clinical records and follow-up information were retrospectively reviewed. The efficacy of the second-line chemotherapy was evaluated, and the survival of these patients was analyzed. COX proportional hazards model analysis was conducted to find out the prognosis-related factors. Results: The median PFS (progression-free survival) in topotecan, platinum-based rechallenge and other single agent groups were 2.80, 4.07 and 1.93 months, respectively (P = 0.007); the median OS (overall survival) from the initiation of second-line chemotherapy in these three groups were 8.07, 10.57 and 7.27 months, respectively (P = 0.021); the rates of grades III-IV toxicities in these three groups were 47.6%, 69.2% and 30.0%, respectively (P = 0.033). The COX proportional hazards model analysis revealed that the factors of response to first-line chemotherapy (response vs stable disease/progression; hazard ratio = 1.27, P = 0.013), performance status score before second-line chemotherapy (0-1 vs 2; hazard ratio = 1.36, P = 0.019), and staging before secondline chemotherapy (limited vs extensive; hazard ratio = 2.16, P = 0.006) were independent prognostic predictors of OS after second-line chemotherapy. Conclusion: The sensitive recurrent SCLC patients who were classified as limited-stage SCLC and having a therapeutic response to first-line chemotherapy and a performance status score of 0-1 may benefit from the second-line chemotherapy. Platinum-based rechallenge as a second-line chemotherapy regimen has an advantage of prolonged PFS and OS as compared with topotecan or other single agent therapy. Copyright © 2012 by TUMOR.

Multiple Hepatic and Paraaortic Lymph Nodes Metastases from Advanced Gastric Cancer Successfully Treated with Oxaliplatin/Leucovorin/5-FU

The treatment for the hepatic and lymph nodes metastases after curative resection of gastric cancer has not yet been established. The different kinds of treatment that have been attempted have not yet shown satisfactory results. We report here on a case of an advanced gastric cancer patient who had multiple hepatic and paraaortic lymph node metastases 4 months after curative resection, and the woman showed a clinical response of complete remission to combination chemotherapy with oxaliplatin, leucovorin and 5-FU. A 62-year-old female patient, who was diagnosed with Borrmann type 3 advanced gastric cancer, underwent distal gastrectomy and D2 lymph nodes dissection. The conclusive stage was stage IIIA: After UFT 400 mg/m(2) was administered for 4 months, abdominal CT scan revealed two hepatic metastases and multiple paraaortic nodal enlargements. She received combination chemotherapy with oxaliplatin 100 mg/m(2) and LV 100 mg/m(2) for a 2-hour infusion at day 1, followed by a 22-hour continuous infusion of 5-FU 1,750 mg/m(2) at days 1 and 2. She remains alive without any evidence of recurrent disease for 47 months after chemotherapy.

Docetaxel as Second-line Monotherapy for Advanced Non-small Cell Lung Cancer / 결핵및호흡기질환

BACKGROUND: The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second-line chemotherapy, for which Docetaxel (Taxotere(R)) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum- based chemotherapy. METHODS: Thirty one patients with non-small-cell lung cancer, who had failed first-line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either 75 mg/m2 or 100 mg/m2, with routine premedication every three weeks. RESULTS: Fourteen patients (45.2%) had a partial response. The median survival and progression-free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age ( or = 60 years: 6.6 months, p = 0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment-related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. CONCLUSION: Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small- cell lung cancer who failed first-line platinum-based chemotherapy.

The role of topotecan as second-line chemotherapy in patients with recurrent epithelial ovarian cancer / 대한산부인과학회지

OBJECTIVE: Topotecan has recently been used as a second-line agent in treatment of advanced ovarian cancer. The aim of the study was to evaluate the response rate and toxicities of topotecan in patients with recurrent epithelial ovarian cancer who had been treated with platinum-containing chemotherapy. METHODS: A retrospective review of all cases of recurrent ovarian cancer treated with topotecan was done. Response was evaluated using the clinical examination, CA-125 level and radiologic reports (CT, MRI) according to RECIST criteria. The toxicities were evaluated according to GOG criteria. RESULTS: Between 1998 and 2004, 57 patients were treated with topotecan for recurrent epithelial ovarian cancer. The response rate in platinum-sensitive group was 30.8% (4/13) and the response rate in platinum-resistant group was 15.9% (7/44). The response rate in topotecan alone therapy group was 8.0% (2/25), and the response rate in topotecan plus platinum combination therapy group was 28.1% (9/32). However, topotecan plus platinum combination therapy did not demonstrate a statistically significant trend toward greater median survival than topotecan alone therapy (19.2 month versus 17.2 month, P=0.82). Neutropenia above grade 3 was noted in 70%, and anemia above grade 3 in 36.8%, and thrombocytopenia above grade 3 in 47.3%. Although most severe toxicities were due to bone marrow suppression, they were adequately managed by supportive care. CONCLUSION: The results suggest that topotecan has moderate activity in the recurrent epithelial ovarian cancer who have failed previous treatment with platinum-containing chemotherapy. The response of topotecan plus platinum combination therapy was better than topotecan alone and the potential of other combination regimen deserves further evaluations.

Gemcitabine Plus Vinorelbine as Second-line Chemotherapy of the Patients of Previously Treated Non-small Cell lung Cancer: Phase II Trial / 결핵및호흡기질환

BACKGROUND: Both gemcitabine and vinorelbine are effective anticancer drugs with mild toxicity on non-small cell lung cancer, and monotherapy of these drugs are effective as a second-line chemotherapy. The aim of this trial was to assess the response and toxicity of a combination of gemcitabine and vinorelbine in patients of previously treated for non-small cell lung cancer. MATERIALS AND METHODS: 24 patients, initial stage III A/B,IV and previously treated with platinium and taxane based regimens, were enrolled from June 2000 to March 2004. The regimens consisted of vinorelbine 25mg/m2 followed by an infusion of gemcitabine 1000mg/m2 on day 1 and day 8 every three weeks. This course was repeated more than twice. RESULTS: Twenty-four patients were analyzed for the response, survival rate, and toxicities. The overall response was 17% with a complete remission rate of 4%. The median time-to progression (TTP) was 3.1 months (95%, CI 1-10months), and the survival time was 8.2 months (95%, CI 1-23 months). The grade 3/4 toxicities encountered were neutropenia (12.5%), anemia (0%), thrombocytopenia (0%). Non-hematological 3/4 toxicities were not observed. CONCLUSION: A combination of gemcitabine and vinorelbine in patients previously treated for non-small cell lung cancer provides a relatively good response rate, and a low toxicity profile. However, further study will be needed to confirm its effectiveness.

Gemcitabine as second-line chemotherapy in patients with recurrent epithelial ovarian cancer: Review of four cases / 대한산부인과학회잡지

Adjuvant multiagent chemotherapy with platinum and paclitaxel after optimal cytoreductive surgery decisively improved survival rates of patients with epithelial ovarian carcinoma. However, more than two- thirds of patients with advanced disease will encounter tumor progression, underlining the need for effective second-line strategies. Continued efforts to discover new active agents for the treatment of patients with ovarian carcinoma had identified gemcitabine. Four patients with epithelial ovarian carcinoma, who were treated in Inje University Sanggye Paik Hospital and recurred thereafter received gemcitabine 1,000 mg/m2 as a 30 min intravenous infusion on days 1, 8, and 15, which was repeated every 28 days. The disease progressed in two patients, while one showed stable disease and another reached complete response. One patient expired of disease two months after the completion of therapy. Grade 3 leukopenia was successfully managed using G-CSF. Regrowth of hair lost during previous chemotherapy occurred in all subjects. We report four cases of advanced recurrent ovarian carcinoma which were treated with gemcitabine.

Phase II Study of Paclitaxel and Cisplatin as Second-line Chemotherapy in Advanced Non-small Cell Lung Cancer / 영남의대학술지

BACKGROUND: To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.

Phase II Study of Gemcitabine and Vinorelbine as Second-Line Chemotherapy in Non-Small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: With the increased use of chemotherapy for non small cell lung cancer (NSCLC), a growing group of patients can now be considered for second-line chemotherapy. However, guidelines for the second line treatment remain to be developed. The objective of this study was to evaluate the efficacy and safety of the gemcitabine and vinorelbine combination therapy in patients with advanced NSCLC, pretreated with taxane and platinum based regimens. Gemcitabine has already demonstrated activity in this patient group, with the combination therapy having been reported to be well tolerated in previous phase I/II studies. MATERIALS AND METHODS: Forty two patients with advanced NSCLC (stages III/IV), having received prior taxane and platinum based chemotherapy, with an ECOG performance status (PS) 0~2, and unimpaired hematopoietic and organ function, were treated with vinorelbine, 20 mg/m2, followed by gemcitabine, 1, 000 mg/m2, both administered on days 1, 8 and 15, every 4 weeks. RESULTS: Out of the 42 patients enrolled, 41 were evaluable for their response, and all 42 for their toxicity. The patient's characteristics were as follows; median age=60 years (42~73), median PS=1 (range 0~2), a gender ratio 31: 11 males/females, with stages IIIA, IIIB and IV in 3, 14 and 25 cases. The objective responses included a partial response (PR) 8/41 (19.5%), a stable disease 15/41 (36.6%) and a progressive disease 18/41 (43.9%). The median time-to progression (TTP) and survival were 4 months, ranging from 2 to 14 months, and 8 months, ranging from 2 to 17+ months, respectively. Grade 3 neutropenia was seen in 19% of the patient, and there was no grade 4 neutropenia or episodes of febrile neutropenia. No grade 4 thrombocytopenia or other grade 3/4 non-hematological toxicities were observed. CONCLUSION: The combination of gemcitabine/vinorelbine is active and well tolerated in patients with advanced NSCLC having failed prior taxane/platinum therapy.

Clinical Study of Topotecan as Second-Line Treatment in Small Cell Lung Cancer / 결핵

BACKGROUND: The majority of chemotherapy-treated small cell lung cancers(SCLC) patients eventually recur. Although many patients are in excellent physical condition at the time of recurrence, few drugs or drug comb inations are capable of effecting a tumor regression in this setting. Topotecan, a topoisomerase I inhibitor, is one of the more widely studied single agents in SCLC. The aim of theis study was to determine the response rate survival and toxicity of topotecan as a second line treatment in SCLS. METHODS: 19 patients with measurable SCLC, progressive during the first line chemotherapy (9 cases) or recurrent after the first line chemotherpy(10 cases), were enrolled in this study. Topotecan was administered as a 30-minute daily infusion at a dose of 1.5mg/m2 for 5 consecutive days, every 3 week. RESULTS: The overall response rate was 26.3%(5/19, CR 2, PR 3, SD3, PD 11). The median survival was 24 weeks. The response rate and survival were poor in the nonresponders during first chemotherapy, those who were refractory to the first chemotherapy (recurrent within 3 months after complection of first chemotherapy and extensive disease, but the results were not statistically significant. The toxicities were mainly hematologic and anemia grade III 1/90, leukopenia grade III 6/90 IV 4/90, thrombocytopenia grade III 1/90 IV 1/90, vomiting grade III 1/90 of cycles were occurred. There was no treatment-related deaths due to severe myelosuppression. CONCLUSION: Topotecan can be an active second line chemotherpeutic agent for treating SCLC.

The results of secondary cytoreductive surgery and second-line chemotherapy for patients with epithelial ovarian cancer / 中国癌症杂志

6 months was 42.3 months, longer than 17.5 months for patients with PFI ≤ 6 months, no statistical significance was found ( P =0.1418). Multivariate analysis strongly suggested that PFI and the courses of second line chemotherapy were independent prognostic factors of survival after secondary treatment for epithelial ovarian cancer. For those patients with PFI ≤ 6 months, the smaller the size of residual lesion ( P =0.0003) and the more the cycle of effective second line chemotherapy ( P =0.0004), the longer the survival after the secondary cytoreduction. Conclusions:The results suggested that successful secondary cytoreductive surgery combined with multicycles second line chemotherapy may be an effective way to lengthen the survival on retreatment for patients with platinum resistant and recurrent epithelial ovarian cancer.

The study progress and second-line chemotherapy of small cell lung cancer / 肿瘤研究与临床

Small cell lung cancer(SCLC) is an chemosensitive and radiosensitive malignant tumor which can appear hematogenous metastasis in early stage. The treatment of SCLC is based on chemotherapy and combined with radiotherapy and operation. In spite of the high response rate, the median time from drug-resistance to death of extensive SCLC is still disappointed. As to limited SCLC, there are still 75 % ~ 80 % patients relapse after inductive chemotherapy and radiotherapy. All in all, the second-line therapy is very important in SCLC patients.