ABSTRACT
PURPOSE: To evaluate the efficacy and toxicity profile of the combination of docetaxel and prolonged gemcitabine infusion in front-line chemonaive patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: A total of 50 chemonaive patients diagnosed with advanced NSCLC according to the AJCC/TNM classification system were included in the present study. Treatment consisted of 1000 mg/m(2) gemcitabine given as a 100-min continuous infusion (10 mg/m(2) per min) on days 1 and 8 of each course and 75 mg/m(2) docetaxel as a 60-min infusion on day 8, repeating each course every 21 days. RESULTS: The ECOG performance status of the patients were as follows: 0 (10%), 1 (60%), and 2 (30%). All patients had two-dimensionally measurable disease. Their median age was 63 years (range 41-75 years). Of the 50 patients, 28 (56%) had squamous cell carcinoma, 14 adenocarcinoma (28%), and 8 (16%) large-cell carcinoma, and 40% and 60% of patients presented with stage IIIB and IV disease, respectively. Of those with stage IV disease, 33% had more than one metastatic site. A total of 220 courses were administered with a median of five courses per patient. Of 46 patients assessed for response, 12 (26%) had a partial remission (95% CI 13-39%). In 19 patients (41%) the disease remained stable, while disease progression was observed in 15 (33%). The median time to disease progression was 4 months, and median survival time was 7 months. At 1 year, 25% of patients remained alive, and the main grade 3/4 toxicity (according to the WHO scale) consisted of neutropenia ( n=6, 12%), asthenia ( n=4, 8%), peripheral edema ( n=3, 6%), dyspnea ( n=3, 6%), and diarrhea ( n=2, 4%). CONCLUSIONS: Prolonged gemcitabine infusion combined with docetaxel is well tolerated and its efficacy is similar to that of other chemotherapeutic schemes used for NSCLC treatment. However, the prolonged infusion of gemcitabine did not appear to result in any improvement in outcome or toxicity versus the standard dose rate.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Deoxycytidine/analogs & derivatives , Deoxycytidine/administration & dosage , Lung Neoplasms/drug therapy , Taxoids/administration & dosage , Adult , Aged , Deoxycytidine/adverse effects , Docetaxel , Female , Humans , Male , Middle Aged , Taxoids/adverse effects , GemcitabineABSTRACT
Plasmatic fibronectin has been studied in tumor patients on the basis of the role that unspecific opsonin may play in tumor growth and spreading. Alterations in fibronectin levels might be used as a biological marker and our purpose has been to evaluate the significance of this test in the biological diagnosis of cancer. When comparing the levels found in the control group (22.86 +/- 1.40 mg/dl) and in tumor patients (23.80 +/- 1.90 mg/dl), we observed no difference in the overall group. However, in relation to the localization of tumors, a significant increase was found in breast cancer (31.83 +/- 3.83 mg/dl) and a significant decrease in squamous cell carcinoma of the head and neck (9.56 +/- 1.68 mg/dl). These results suggest that plasmatic fibronectin could be useful as a biomarker in some types of tumors. Our conclusion was confirmed by analysis of ROC curves related to every one of the studied tumors.
Subject(s)
Biomarkers, Tumor/blood , Fibronectins/blood , Neoplasms/blood , Adolescent , Adult , Aged , Breast Neoplasms/blood , Child , Female , Head and Neck Neoplasms/blood , Humans , Lung Neoplasms/blood , Lymphoma/blood , Male , Middle Aged , Neoplasms/diagnosis , ROC CurveSubject(s)
Anemia, Hemolytic, Autoimmune/immunology , Leukemia, Lymphocytic, Chronic, B-Cell/immunology , Anemia, Hemolytic, Autoimmune/complications , Anemia, Hemolytic, Autoimmune/drug therapy , Antibodies/immunology , Antineoplastic Agents/therapeutic use , Complement C3/immunology , Coombs Test , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Male , Methylprednisolone/therapeutic use , Middle AgedSubject(s)
Anemia/etiology , Liver Diseases/complications , Adult , Erythrocyte Indices , Female , Hematocrit , Hepatitis/complications , Humans , Liver Cirrhosis/complications , Liver Diseases/blood , Male , Middle AgedABSTRACT
Assessment of the accuracy of diagnostic procedures is made independent of diagnostic criteria by means of a receiver-operating-characteristics (ROC) curve. We performed ROC analysis for the major serum antiproteases: alpha-1-antitrypsin (A1AT) and alpha-2-macroglobulin (A2M), in 99 cancer patients compared with 71 normal individuals. A1AT and A2M were significantly higher in cancer patients (p less than 0.0005). By comparing true positive and false positive rates for different serum levels, ROC analysis showed that serum A1AT quantification seems more useful in clinical practice than serum A2M.
Subject(s)
Biomarkers, Tumor/blood , Neoplasms/diagnosis , ROC Curve , alpha 1-Antitrypsin/analysis , alpha-Macroglobulins/analysis , Adult , Female , Humans , Male , Middle AgedABSTRACT
The two major antiproteases (alpha-1-antitrypsin and alpha-2-macroglobulin) were studied in the serum of cancer patients (273 and 103 subjects, respectively) and in a control group. In cancer patients, the values were stratified by clinical stage (local, loco-regional and metastatic disease). Serum alpha-1-antitrypsin was different in normal people (341 +/- 110.7 mg/dl) than in every cancer group (p less than 0.0005). The behavior of alpha-2-macroglobulin was similar, with significant differences (p less than 0.0005) between normal people (317.6 +/- 105.4 mg/dl) and the cancer groups. Serum alpha-1-antitrypsin was different in local, loco-regional and metastatic disease; however, alpha-2-macroglobulin did not show these differences. In metastatic disease, sensitivity was 96.66% for alpha-1-antitrypsin and 94.79% for alpha-2-macroglobulin.
