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Tai CJ, Wang CK, Tai CJ, Tzao C, Lien YC, Hsieh CC, Hsieh CI, Wu HC, Wu CH, Chang CC, Chen RJ, Chiou HY. Evaluation of Safety and Efficacy of Salvage Therapy With Sunitinib, Docetaxel (Tyxan) and Cisplatinum Followed by Maintenance Vinorelbine for Unresectable/Metastatic Nonsmall Cell Lung Cancer: Stage 1 of a Simon 2 Stage Clinical Trial. [Corrected]. Medicine (Baltimore) 2015; 94:e2303. [PMID: 26717366 PMCID: PMC5291607 DOI: 10.1097/md.0000000000002303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Current chemotherapeutic regimens for nonsmall cell lung cancer (NSCLC) have reached a plateau over the last few years. Targeted therapy makes use of tyrosine kinase inhibitors (TKIs) to suppress a number of signaling pathways including epidermal growth factor receptor and vascular endothelial growth factor which are active in NSCLC biology. In this study, we used sunitinib, a multi-target receptor TKI, combined with chemotherapy for unresectable/metastatic NSCLC.This open label Simon's 2 stage clinical trial enrolled a total of 6 NSCLC patients who received docetaxel (40 mg) and cisplatin (50 mg) on day 1 of each cycle (14 day interval between cycles) and sunitinib (25 mg qd for 10 days between cycles) for a total of 12 cycles (24 weeks), after which patients received maintenance therapy with vinorelbine (30 mg TIW) until disease progression. The sample size was based on a Simon's Optimal Two-Stage Designs for Phase II clinical trials. The expected response rate was set as 35% for P0 and as 60% for P1. The study was designed for a minimum of 6 patients for first stage and 15 patients until second stage with a significance level alpha = 0.10 and power = 70%. Diagnosis of a poor response in the second of 6 patients in Stage I or seventh of the 15 patients in Stage II would lead to early termination of the trial.The overall response rate was 66.7%. Four patients had an overall survival >60 months. The time to PFS ranged from 3 to 42 months. The combination therapy was well-tolerated.Sunitinib combined with chemotherapy shows promise and warrants further investigation.
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Affiliation(s)
- Cheng-Jeng Tai
- From the Division of Hematology and Oncology, Department of Internal Medicine (C-JT, C-KW, C-IH, H-CW), Department of Chinese Medicine (C-KW, C-JT), Traditional Herbal Medicine Research Center (C-JT), Division of Thoracic Surgery, Department of Surgery (CT, Y-CL), Division of Gastroenterology, Department of Internal Medicine (C-CC), and Division of General Surgery, Department of Surgery (R-JC), Taipei Medical University Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine (C-JT, C-KW, C-IH, H-CW, C-CC), Department of Obstetrics and Gynecology, School of Medicine, College of Medicine (C-KW, C-JT), Graduate Institute of Clinical Medicine, College of Medicine (CT), Department of Surgery, School of Medicine, College of Medicine (Y-CL, C-HW, R-JC), Center of Excellence for Cancer Research (C-HW), and School of Public Health, College of Public Health and Nutrition (H-YC), Taipei Medical University, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan (C-CH), and Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan (C-HW)
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Ball D. Curing Non–Small Cell Lung Cancer With Radiotherapy: No Longer an Oxymoron. Semin Radiat Oncol 2015; 25:65-6. [DOI: 10.1016/j.semradonc.2014.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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