Cancer Research and Treatment

Original Articles

Hematologic malignancy

A Phase II Study to Evaluate the Efficacy of Bortezomib in Combination with Thalidomide in Treatment-Naïve Waldenstrom Macroglobulinemia Patients: Ja Min Byun, Junghoon Shin, Sang-A Kim, Hyunkyung Park, Jiyun Lee, Dong-Yeop Shin, Junshik Hong, Jeong-Ok Lee, Soo-Mee Bang, Inho Kim, Sung-Soon Yoon, Youngil Koh; Cancer Res Treat. 2024;56(2):675-680. Published online September 25, 2023; DOI: https://doi.org/10.4143/crt.2023.681

Abstract PDF PubReader ePub: Purpose
Despite the recent success of Bruton’s tyrosine kinase (BTK) inhibitors for the treatment of Waldenstrom macroglobulinemia (WM), their indefinite treatment duration ultimately tantamount to substantial financial and emotional burden. On the other hand, fixed duration of proteasome inhibitors (PI) have shown rapid and reasonable response in WM treatment. Despite the well-known synergism between PI and immunomodulatory drugs (IMiD), there is no trials evaluating such combination in WM.
Materials and Methods
Based on above, we designed this phase II study to investigate the efficacy and safety of 6 cycles of 28-day bortezomib-thalidomide-dexamethasone (VTD) regimen for treatment-naïve WM.
Results
A total of 15 patients were enrolled: major response rate was 64.3%, and overall response rate was 78.6%. During the median follow-up of 41 months, median progression-free survival (PFS) was 13 months and overall survival 40 months. For responders, median duration of response was 13 months and median PFS 19 months. The most common adverse event (AE) of any grade was constipation (57.1%). The most common grade ≥ 3 AE was anemia (21.4%).
Conclusion
All in all, we hereby provide proof-of-concept that PI + IMiD may be an attractive backbone for fixed duration treatment. It should be noted that granting the same level of access to newer drugs globally is virtually impossible. Thus efforts to develop regimens using readily available drugs to yield similar or adequate treatment outcomes should not be disregarded. In this sense, we believe our study holds its place for its novelty and eloquently addresses achieving the daunting societal quest of health equity.

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Prognostic Factors for Risk Stratification of Patients with Recurrent or Metastatic Pancreatic Adenocarcinoma Who Were Treated with Gemcitabine-Based Chemotherapy: Inkeun Park, Seung Joon Choi, Young Saing Kim, Hee Kyung Ahn, Junshik Hong, Sun Jin Sym, Jinny Park, Eun Kyung Cho, Jae Hoon Lee, Yong Ju Shin, Dong Bok Shin; Cancer Res Treat. 2016;48(4):1264-1273. Published online March 23, 2016; DOI: https://doi.org/10.4143/crt.2015.250

Abstract PDF PubReader ePub

Purpose
The aim of this study was to verify prognostic factors including sarcopenia in patients with recurrent or metastatic pancreatic cancer receiving gemcitabine-based chemotherapy. Materials and Methods Medical records and computed tomography scan of consecutive patients treated with palliative gemcitabine-based chemotherapy from 2008 to 2014 were reviewed. The lumbar skeletal muscle index at third lumbar spine level was computed, and together with clinicolaboratory factors, univariate and multivariable analyses for overall survival (OS) were performed.
Results
A total of 88 patients were found. Median age was 65 years, and male patients were predominant (67.0%). Most patients had initially metastatic disease (72.7%), and gemcitabine monotherapy was administered in 29 patients (33.0%) while gemcitabine plus erlotinib was administered in 59 patients (67.0%). Seventy-six patients (86.3%) had sarcopenia. With a median follow-up period of 44.3 months (range, 0.6 to 44.3 months), median OS was 5.35 months (95% confidence interval [CI], 4.11 to 6.59). In univariate and multivariable analysis, high carcinoembryonic antigen level (hazard ratio [HR], 4.18; 95% CI, 1.95 to 8.97; p < 0.001), initially metastatic disease (HR, 3.37; 95% CI, 1.55 to 7.32; p=0.002), sarcopenia (HR, 2.97; 95% CI, 1.20 to 7.36; p=0.019), neutrophilia (HR, 2.94; 95% CI, 1.27 to 6.79; p=0.012), and high lactate dehydrogenase level (HR, 1.96; 95% CI, 1.07 to 3.58; p=0.029) were identified as independent prognostic factors for OS. Conclusion Five independent prognostic factors in patients with recurrent or metastatic pancreatic cancer who received gemcitabine-based chemotherapy were identified. These findings may be helpful in prediction of prognosis in clinical practice and can be used as a stratification factor for clinical trials.

Citations

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Academic Radiology.2023; 30(8): 1552. CrossRef
Pre-Therapeutic Sarcopenia among Cancer Patients: An Up-to-Date Meta-Analysis of Prevalence and Predictive Value during Cancer Treatment
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Kittipitch Bannangkoon, Keerati Hongsakul, Teeravut Tubtawee, Natee Ina, Ply Chichareon
Scientific Reports.2023;[Epub] CrossRef
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Li Yang, Xianghui Liao, Zhong Xie, Haiwen Li
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Sarkopenie als unabhängiger Prognosefaktor bei Pankreaskarzinom
Johanna Mandl, Sebastian Baumer, Bernadette Holtzem, Rainer Theurer, Niels Zorger, Oliver Pech
TumorDiagnostik & Therapie.2023; 44(10): 696. CrossRef
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Chiara Cencioni, Ilaria Trestini, Geny Piro, Emilio Bria, Giampaolo Tortora, Carmine Carbone, Francesco Spallotta
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Hiroyuki Asama, Makoto Ueno, Satoshi Kobayashi, Taito Fukushima, Kuniyuki Kawano, Yusuke Sano, Satoshi Tanaka, Shuhei Nagashima, Manabu Morimoto, Hiromasa Ohira, Shin Maeda
Pancreas.2022; 51(2): 148. CrossRef
Prognostic significance of sarcopenia as determined by bioelectrical impedance analysis in patients with advanced pancreatic cancer receiving gemcitabine plus nab‑paclitaxel: A retrospective study
Yuichiro Tozuka, Makoto Ueno, Satoshi Kobayashi, Manabu Morimoto, Taito Fukushima, Yusuke Sano, Kuniyuki Kawano, Akane Hanaoka, Shun Tezuka, Hiroyuki Asama, Satoshi Moriya, Soichiro Morinaga, Shinichi Ohkawa, Shin Maeda
Oncology Letters.2022;[Epub] CrossRef
Body composition as a predictor of chemotherapy-related toxicity in pancreatic cancer patients: A systematic review
Stefania Rizzo, Isabel Scala, Angela Rodriguez Robayo, Marco Cefalì, Sara De Dosso, Stefano Cappio, Genti Xhepa, Filippo Del Grande
Frontiers in Oncology.2022;[Epub] CrossRef
Dynamic changes in the body composition during chemotherapy for gastrointestinal tumors in the context of active nutrition intervention
Ting Xu, Zhenhao Li, Hui Li, Jixiang Hou, Jingjing Li, Gaowa Jin, Shaohua Li, Quanfu Li
Frontiers in Oncology.2022;[Epub] CrossRef
Prognostic value of skeletal muscle mass during tyrosine kinase inhibitor (TKI) therapy in cancer patients: a systematic review and meta-analysis
Emanuele Rinninella, Marco Cintoni, Pauline Raoul, Francesca Romana Ponziani, Maurizio Pompili, Carmelo Pozzo, Antonia Strippoli, Emilio Bria, Giampaolo Tortora, Antonio Gasbarrini, Maria Cristina Mele
Internal and Emergency Medicine.2021; 16(5): 1341. CrossRef
Clinical significance of skeletal muscle density and sarcopenia in patients with pancreatic cancer undergoing first-line chemotherapy: a retrospective observational study
In-Ho Kim, Moon Hyung Choi, In Seok Lee, Tae Ho Hong, Myung Ah. Lee
BMC Cancer.2021;[Epub] CrossRef
The impact of body composition on short-term outcomes of neoadjuvant chemotherapy with gemcitabine plus S-1 in patients with resectable pancreatic cancer
Tsuyoshi Takeda, Takashi Sasaki, Takafumi Mie, Takaaki Furukawa, Yuto Yamada, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
Japanese Journal of Clinical Oncology.2021; 51(4): 604. CrossRef
Prognostic significance of skeletal muscle decrease in unresectable pancreatic cancer: Survival analysis using the Weibull exponential distribution model
Hiroki Sato, Takuma Goto, Akihiro Hayashi, Hidemasa Kawabata, Tetsuhiro Okada, Shuhei Takauji, Junpei Sasajima, Katsuro Enomoto, Mikihiro Fujiya, Kyohei Oyama, Yusuke Ono, Ayumu Sugitani, Yusuke Mizukami, Toshikatsu Okumura
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Jingyong Xu, Junmin Wei
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Maintenance of skeletal muscle mass during FOLFIRINOX is a favorable prognostic factor in pancreatic cancer patients
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BMC Research Notes.2021;[Epub] CrossRef
Depletion of Psoas Muscle Mass after Systemic Chemotherapy Is Associated with Poor Prognosis in Patients with Unresectable Pancreatic Cancer
Naoto Iwai, Takashi Okuda, Kohei Oka, Junichi Sakagami, Taishi Harada, Tomoya Ohara, Chie Hattori, Masashi Taniguchi, Hiroaki Sakai, Tasuku Hara, Toshifumi Tsuji, Toshiyuki Komaki, Keizo Kagawa, Osamu Dohi, Hiroaki Yasuda, Yoshito Itoh
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Pancreas.2021; 50(7): 933. CrossRef
Influence of sarcopenia in major pancreatic surgery. A systematic review of the literature
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Gastroenterología y Hepatología.2020; 43(3): 142. CrossRef
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Fleur van der Sijde, Eveline E. Vietsch, Dana A.M. Mustafa, Yunlei Li, Casper H.J. van Eijck
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Raquel Aranzazu Latorre Fragua, Alba Manuel Vázquez, Carmen Ramiro Pérez, Roberto de la Plaza Llamas, José Manuel Ramia Ángel
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Impact of progressive resistance training on CT quantified muscle and adipose tissue compartments in pancreatic cancer patients
Raoul Wochner, Dorothea Clauss, Johanna Nattenmüller, Christine Tjaden, Thomas Bruckner, Hans-Ulrich Kauczor, Thilo Hackert, Joachim Wiskemann, Karen Steindorf, Leonardo A. Peyré-Tartaruga
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Prognostic factors in patients with metastatic or recurrent pancreatic cancer treated with first-line nab-paclitaxel plus gemcitabine: implication of inflammation-based scores
Inhwan Hwang, Jihoon Kang, Hei Nga Natalie Ip, Jae Ho Jeong, Kyu-pyo Kim, Heung-Moon Chang, Changhoon Yoo, Baek-Yeol Ryoo
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Significance of the inflammation-based prognostic score in recurrent pancreatic cancer
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Sachiyo Onishi, Masahiro Tajika, Tsutomu Tanaka, Yutaka Hirayama, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Yoshitaka Inaba, Takeshi Kodaira, Tetsuya Abe, Kei Muro, Masahito Shimizu, Yasumasa Niwa
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Therapeutic Advances in Medical Oncology.2019;[Epub] CrossRef
Sarcopenia Predicts Prognosis in Patients with Newly Diagnosed Hepatocellular Carcinoma, Independent of Tumor Stage and Liver Function
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Dietary fat stimulates pancreatic cancer growth and promotes fibrosis of the tumor microenvironment through the cholecystokinin receptor
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Randomized Phase II Study of Pemetrexed Versus Gefitinib in Previously Treated Patients with Advanced Non-small Cell Lung Cancer: Young Saing Kim, Eun Kyung Cho, Hyun Sun Woo, Junshik Hong, Hee Kyung Ahn, Inkeun Park, Sun Jin Sym, Sun Young Kyung, Shin Myung Kang, Jeong-Woong Park, Sung Hwan Jeong, Jinny Park, Jae Hoon Lee, Dong Bok Shin; Cancer Res Treat. 2016;48(1):80-87. Published online March 2, 2015; DOI: https://doi.org/10.4143/crt.2014.307

Abstract PDF PubReader ePub

Purpose
This study aimed to evaluate the efficacy and safety of pemetrexed versus gefitinib in patients with advanced non-small cell lung cancer (NSCLC) previously treated with chemotherapy. Materials and Methods Patients with advanced (stage IIIB or IV) or recurrent NSCLC were randomly assigned to receive either 500 mg/m² of pemetrexed intravenously every 3 weeks or gefitinib 250 mg/day orally. The primary end point was progression-free survival (PFS) at 6 months.
Results
A total of 95 patients were enrolled (47 for pemetrexed and 48 for gefitinib). Most patients were male (72%) and current/ex-smokers (69%), and 80% had non-squamous cell carcinoma. The epidermal growth factor receptor (EGFR) mutation status was determined in 38 patients (40%); one patient per each arm was positive for EGFRmutation. The 6-month PFS rates were 22% and 15% for pemetrexed and gefitinib, respectively (p=0.35). Both arms showed an identical median PFS of 2.0 months and a median overall survival (OS) of 8.5 months. In EGFR wild-type patients, higher response rate (RR) and longer PFS as well as OS were achieved via pemetrexed compared with gefitinib, although there were no significant differences (RR: 39% vs. 9%, p=0.07; median PFS: 6.6 months vs. 3.1 months, p=0.45; median OS: 29.6 months vs. 12.9 months, p=0.62). Toxicities were mild in both treatment arms. Frequently reported toxicities were anemia and fatigue for pemetrexed, and skin rash and anorexia for gefitinib. Conclusion Both pemetrexed and gefitinib had similar efficacy with good tolerability as second-line treatment in unselected patients with advanced NSCLC. However, pemetrexed is considered more effective than gefitinib for EGFR wild-type patients.

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Adverse event profiles of EGFR-TKI: network meta-analysis and disproportionality analysis of the FAERS database
Jing Shi, Xinya Liu, Mengjiao Gao, Jian Yu, Ting Chai, Yun Jiang, Jiawei Li, Yuanming Zhang, Li Wu
Frontiers in Pharmacology.2025;[Epub] CrossRef
A network meta-analysis of immunotherapy-based treatments for advanced nonsquamous non-small cell lung cancer
Himani Aggarwal, Kerigo Ndirangu, Katherine B Winfree, Catherine Elizabeth Muehlenbein, Emily Zhu, Vanita Tongbram, Howard Thom
Journal of Comparative Effectiveness Research.2023;[Epub] CrossRef
Toxicity profile of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung cancer: A systematic review and network meta-analysis
Yi Zhao, Bo Cheng, Zisheng Chen, Jianfu Li, Hengrui Liang, Ying Chen, Feng Zhu, Caichen Li, Ke Xu, Shan Xiong, Weixiang Lu, Zhuxing Chen, Ran Zhong, Shen Zhao, Zhanhong Xie, Jun Liu, Wenhua Liang, Jianxing He
Critical Reviews in Oncology/Hematology.2021; 160: 103305. CrossRef
Efficacy and Safety of Pemetrexed and Gefitinib in the Treatment of Non-Small-Cell Lung Cancer: A Meta-Analysis
Zhihao Zhang, Xiyong Wang, Huaiqing Xiao, Dongqiang Wu, Dongliang Zhang, Qun Yu, Linna Yuan, Tao Huang
Computational and Mathematical Methods in Medicine.2021; 2021: 1. CrossRef
A meta-analysis of the safety and effectiveness of pemetrexed compared with gefitinib for pre-treated advanced or metastatic NSCLC
Xiaoxin Lu, Shengshu Li, Weizong Chen, Dongyang Zheng, Yuzhu Li, Fang Li
Medicine.2020; 99(29): e21170. CrossRef
Pemetrexed versus Gefitinib as Second-line Treatment for Advanced Non-small Cell Lung Cancer: A Meta-analysis Based on Randomized Controlled Trials
Huiyu Wang, Zunjing Zhang, Feng Liu, Miaoying Zhou, Handi Lv
Pteridines.2019; 30(1): 171. CrossRef
Gefitinib for advanced non-small cell lung cancer
Esther HA Sim, Ian A Yang, Richard Wood-Baker, Rayleen V Bowman, Kwun M Fong
Cochrane Database of Systematic Reviews.2018;[Epub] CrossRef
Pneumonitis in advanced non-small-cell lung cancer patients treated with EGFR tyrosine kinase inhibitor: Meta-analysis of 153 cohorts with 15,713 patients
Chong Hyun Suh, Hye Sun Park, Kyung Won Kim, Junhee Pyo, Hiroto Hatabu, Mizuki Nishino
Lung Cancer.2018; 123: 60. CrossRef
Second-Line Treatment of NSCLC—The Pan-ErbB Inhibitor Afatinib in Times of Shifting Paradigms
Jens Köhler
Frontiers in Medicine.2017;[Epub] CrossRef

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Treatment Outcomes of Rituximab Plus Hyper-CVAD in Korean Patients with Sporadic Burkitt or Burkitt-like Lymphoma: Results of a Multicenter Analysis: Junshik Hong, Seok Jin Kim, Jae-Sook Ahn, Moo Kon Song, Yu Ri Kim, Ho Sup Lee, Ho-Young Yhim, Dok Hyun Yoon, Min Kyoung Kim, Sung Yong Oh, Yong Park, Yeung-Chul Mun, Young Rok Do, Hun-Mo Ryoo, Je-Jung Lee, Jae Hoon Lee, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2015;47(2):173-181. Published online October 28, 2014; DOI: https://doi.org/10.4143/crt.2014.055

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma (BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD) regimen by focusing on tolerability and actual delivered relative dose intensity (RDI).
Materials and Methods
Patients ≥ 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphoma were treated with at least one cycle of R-hyper-CVAD as the first-line treatment in this study. Eligible patients’ case report forms were requested from their physicians to obtain clinical and laboratory data for this retrospective study.
Results
Forty-three patients (median age, 51 years) from 14 medical centers in Korea were analyzed, none of which were infected with human immunodeficiency virus. The majority of patients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rates were 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete the R-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin, vincristine, methotrexate, and cytarabine were between 60% and 65%, which means less than 25% of patients received greater than 80% of the planned dose of each drug. Poor performance status was related to the lower RDIs of doxorubicin and methotrexate.
Conclusion
R-hyper-CVAD showed excellent treatment outcomes in patients who were suitable for dose-intense chemotherapy. However, management of patients who are intolerant to a dose-intense regimen remains problematic due to the frequent occurrence of treatmentrelated complications.

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Xiaoxuan Lu, Yu Liu, Ruyu Liu, Jiaxin Liu, Xiaojing Yan, Liren Qian
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Trends in survival of patients with stage I/II Burkitt lymphoma in the United States: A SEER database analysis
Ze‐Long Liu, Pan‐Pan Liu, Xi‐Wen Bi, De‐Xin Lei, Yu Wang, Zhi‐Ming Li, Wen‐Qi Jiang, Yi Xia
Cancer Medicine.2019; 8(3): 874. CrossRef
ERK-dependent IL-6 positive feedback loop mediates resistance against a combined treatment using danusertib and BKM120 in Burkitt lymphoma cell lines
Jun Liu, Junshik Hong, Kwang-Sung Ahn, Junhyeok Go, Heejoo Han, Jihyun Park, Dongchan Kim, Hyejoo Park, Youngil Koh, Dong-Yeop Shin, Sung-Soo Yoon
Leukemia & Lymphoma.2019; 60(10): 2532. CrossRef
Lymphoma epidemiology in Korea and the real clinical field including the Consortium for Improving Survival of Lymphoma (CISL) trial
Kwai Han Yoo, Hyewon Lee, Cheolwon Suh
International Journal of Hematology.2018; 107(4): 395. CrossRef
Recent advances in treating extra-ocular lymphomas
Lauge Hjorth Mikkelsen, Natacha Storm Würtz, Steffen Heegaard
Expert Review of Ophthalmology.2018; 13(4): 205. CrossRef
The Consortium for Improving Survival of Lymphoma (CISL): recent achievements and future perspective
Cheolwon Suh, Byeong-Bae Park, Won Seog Kim
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Primary lymphomas in the gastrointestinal tract
Jiang Chen Peng, Lu Zhong, Zhi Hua Ran
Journal of Digestive Diseases.2015; 16(4): 169. CrossRef

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Case Report

Oxaliplatin-Induced Immune-Mediated Thrombocytopenia: A Case Report: Hyun Sun Woo, Kyoung Hwa Lee, Phill Hoon Yoon, Su Ji Kim, Inkeun Park, Young Saing Kim, Hee Kyung Ahn, Junshik Hong, Dong Bok Shin, Sun Jin Sym; Cancer Res Treat. 2015;47(4):949-953. Published online October 28, 2014; DOI: https://doi.org/10.4143/crt.2014.052

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Oxaliplatin is a third-generation platinum derivative used for metastatic or advanced colorectal cancer treatment. Although myelosuppression is the most common cause of oxaliplatin-induced thrombocytopenia, rare cases of oxaliplatin-induced immunemediated thrombocytopenia are reported. We report a case of a 57-year-old woman with colon cancer who developed gum bleeding and petechiae after oxaliplatin infusion. Laboratory tests revealed grade 4 thrombocytopenia and grade 4 neutropenia. She recovered from the thrombocytopenia and accompanying neutropenia within 4 days with no recurrence following discontinuation of oxaliplatin. Physicians need to be aware of the risk of severe acute thrombocytopenia following oxaliplatin administration.

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Risk Factors of Chemotherapy-Induced Thrombocytopenia After Oxaliplatin-Containing Chemotherapy for Gastrointestinal Malignancies
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Original Article

Oxaliplatin, 5-fluorouracil and Leucovorin (FOLFOX-4) Combination Chemotherapy as a Salvage Treatment in Advanced Gastric Cancer: Young Saing Kim, Junshik Hong, Sun Jin Sym, Se Hoon Park, Jinny Park, Eun Kyung Cho, Jae Hoon Lee, Dong Bok Shin; Cancer Res Treat. 2010;42(1):24-29. Published online March 31, 2010; DOI: https://doi.org/10.4143/crt.2010.42.1.24

Abstract PDF PubReader ePub

Purpose

This study was designed to determine the efficacy and safety of FOLFOX-4 chemotherapy as a salvage treatment for patients with advanced gastric cancer (AGC).

Materials and Methods

The AGC patients with an ECOG performance status of 0~1 and progressive disease after prior treatments were registered onto this phase II trial. The patients received oxaliplatin (85 mg/m² on day 1), leucovorin (200 mg/m² on days 1 and 2) and 5-fluorouracil (400 mg/m² as a bolus and 600 mg/m² as a 22-hour infusion on days 1 and 2) every 2 weeks.

Results

For the 42 treated patients, a total of 228 chemotherapy cycles (median: 5, range: 1~12) were administered. Twenty-nine patients (69%) received FOLFOX-4 chemotherapy as a third-(50%) or fourth-line (19%) treatment. On the intent-to-treat analysis, 9 patients (21%) achieved a partial response, which was maintained for 4.6 months. The median progression-free survival and overall survival were 3.0 months and 6.2 months, respectively. The frequently encountered toxicities were neutropenia and gastrointestinal side effects, including anorexia. Although there was one possible treatment-related death, the toxicity profiles were generally predictable and manageable.

Conclusion

Salvage chemotherapy with FOLFOX-4 is an effective and tolerable regimen for those heavily pretreated AGC patients who have a good performance status.

Citations

Citations to this article as recorded by

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