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Lordick F, Lorenzen S, Stollfuss J, Vehling-Kaiser U, Kullmann F, Hentrich M, Zumschlinge R, Dietzfelbinger H, Thoedtmann J, Hennig M, Seroneit T, Bredenkamp R, Duyster J, Peschel C. Phase II study of weekly oxaliplatin plus infusional fluorouracil and folinic acid (FUFOX regimen) as first-line treatment in metastatic gastric cancer. Br J Cancer 2005; 93:190-4. [PMID: 16012522 PMCID: PMC2361546 DOI: 10.1038/sj.bjc.6602697] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Oxaliplatin plus fluorouracil/folinic acid (5-FU/FA) every 2 weeks has shown promising activity in advanced gastric cancer. This study assessed the efficacy and safety of weekly oxaliplatin plus 5-FU/FA (FUFOX regimen) in the metastatic setting. Patients with previously untreated metastatic gastric cancer received oxaliplatin (50 mg m−2) plus FA (500 mg m−2, 2-h infusion) followed by 5-FU (2000 mg m−2, 24-h infusion) given on days 1, 8, 15 and 22 of a 5-week cycle. The primary end point of this multicentre phase II study was the response rate according to RECIST criteria. A total of 48 patients were enrolled. Median age was 62 years and all patients had metastatic disease, with a median number of three involved organs. The most common treatment-related grade 3/4 adverse events were diarrhoea (17%), deep vein thrombosis (15%), neutropenia (8%), nausea (6%), febrile neutropenia (4%), fatigue (4%), anaemia (4%), tumour bleeding (4%), emesis (2%), cardiac ischaemia (2%) and pneumonia (2%). Grade 1/2 sensory neuropathy occurred in 67% of patients but there were no episodes of grade 3 neuropathy. Intent-to-treat analysis showed a response rate of 54% (95% CI, 39–69%), including two complete responses. At a median follow-up of 18.1 months (range 11.2–26.2 months), median survival is 11.4 months (95% CI, 8.0–14.9 months) and the median time to progression is 6.5 months (95% CI, 3.9–9.2 months). The weekly FUFOX regimen is well tolerated and shows notable activity as first-line treatment in metastatic gastric cancer.
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Affiliation(s)
- F Lordick
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. E-mail:
| | - S Lorenzen
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - J Stollfuss
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - U Vehling-Kaiser
- Oncological Outpatient Clinic, Heilig-Geist-Gasse 411, 84028 Landshut, Germany
| | - F Kullmann
- University Clinic of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - M Hentrich
- Clinic Harlaching, Sanatoriumsplatz 2, 81545 Munich, Germany
| | - R Zumschlinge
- Clinic Traunstein, Cuno-Niggl-Str. 3, 83278 Traunstein, Germany
| | | | - J Thoedtmann
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - M Hennig
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - T Seroneit
- Sanofi-Aventis Group, Potsdamer Str. 8, 10785 Berlin, Germany
| | - R Bredenkamp
- Center for Clinical Studies, Ismaninger Str. 22, 81675 Munich, Germany
| | - J Duyster
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - C Peschel
- Clinic Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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Hildebrandt B, Hegewisch-Becker S, Kerner T, Nierhaus A, Bakhshandeh-Bath A, Janni W, Zumschlinge R, Sommer H, Riess H, Wust P. Current status of radiant whole-body hyperthermia at temperatures >41.5 degrees C and practical guidelines for the treatment of adults. The German 'Interdisciplinary Working Group on Hyperthermia'. Int J Hyperthermia 2005; 21:169-83. [PMID: 15764358 DOI: 10.1080/02656730400003401] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The term 'extreme' whole-body hyperthermia (WBH) describes the procedure of raising a patients' body-core temperature to 41.5-42.0 degrees C for 60 min. WBH represents the only hyperthermia technique that enables systemic heat treatment in patients with disseminated malignancies and is, therefore, usually combined with systemic chemotherapy. Up to now, several WBH-approaches have proved to be safe and associated with acceptable toxicity rates when radiant heat devices are employed. Until the late 1990s, the use of radiant WBH was restricted to a few specialized treatment centres worldwide. During the last 5 years, a larger number of WBH-devices were put into operation particularly in Germany. As a result, a novel generation on phase II trials on chemotherapy and adjunctive WBH in patients with various malignancies has been completed. Based on the promising results observed herein, first multi-centric phase III-trials on chemotherapy +/- WBH have been initiated, with a considerable number of patients treated at German institutions. The authors are members of the 'Interdisciplinary Working Group for Hyperthermia' ('Interdisziplinäre Arbeitsgruppe Hyperthermie'), a sub-group of the German Cancer Society. They formulated these guidelines in order to standardize the WBH treatment procedure and supportive measures, to provide some uniformity in the selection of patients to be treated and to define criteria of a successful WBH-treatment. These recommendations may be helpful to ensure the quality of WBH performed at different institutions.
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Affiliation(s)
- B Hildebrandt
- Medizinische Klink für Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany.
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Duyster J, Lorenzen S, Kullmann F, Hentrich M, Zumschlinge R, Vehling-Kaiser U, Seroneit T, Bredenkamp R, Peschel C, Lordick F. Oxaliplatin plus 5FU/folinic acid (FUFOX Regimen) in 1st line metastatic gastric cancer (MGC). Results of the Multicenter Phase II STOMOX Trial. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. Duyster
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - S. Lorenzen
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - F. Kullmann
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - M. Hentrich
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - R. Zumschlinge
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - U. Vehling-Kaiser
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - T. Seroneit
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - R. Bredenkamp
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - C. Peschel
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
| | - F. Lordick
- Tech Univ Muenchen, Munich, Germany; Klin der Univ, Regensburg, Germany; Krankenhaus Harlaching, Munich, Germany; Klin, Traunstein, Germany; Onkologische Schwerpunktpraxis, Landshut, Germany; Sanofi-Aventis Group, Berlin, Germany
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Bakhahandeh A, Wiedemann G, Zabel P, Dalhoff K, Kohlmann T, Zumschlinge R, Penzel D, Wagner T, Peters S. Randomized trial with ICE (ifosfamide, carboplatin, etoposide) plus whole body hyperthermia versus ICE chemotherapy for malignant pleural mesothelioma. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Bakhahandeh
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - G. Wiedemann
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - P. Zabel
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - K. Dalhoff
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - T. Kohlmann
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - R. Zumschlinge
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - D. Penzel
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - T. Wagner
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
| | - S. Peters
- Universitätsklinikum Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Oberschwaben Klinik Ravensburg, Ravensburg, Germany; Forschungszentrum Borstel, Borstel, Germany; Universität Greifswald, Greifswald, Germany; Kreiskliniken Traunstein-Trostberg, Traunstein, Germany; Krankenhaus Bremen Ost, Bremen, Germany
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Bakhshandeh A, Bruns I, Traynor A, Robins HI, Eberhardt K, Demedts A, Kaukel E, Koschel G, Gatzemeier U, Kohlmann T, Dalhoff K, Ehlers EM, Gruber Y, Zumschlinge R, Hegewisch-Becker S, Peters SO, Wiedemann GJ. Ifosfamide, carboplatin and etoposide combined with 41.8 degrees C whole body hyperthermia for malignant pleural mesothelioma. Lung Cancer 2003; 39:339-45. [PMID: 12609573 DOI: 10.1016/s0169-5002(02)00536-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We performed a phase II study combining 41.8 degrees C whole body hyperthermia with ICE chemotherapy, i.e. ifosfamide (5 g/m(2)), carboplatin (300 mg/m(2)) and etoposide (150 mg/m(2) on days 2 and 3), administered every 4 weeks, for patients with malignant pleural mesothelioma. Of 27 chemonäive, non-metastatic patients enrolled, 25 patients were evaluable for response. Overall response rate was 20% (five partial remissions; 95% CI 8.9-39.1%). Median survival time from the start of treatment for all patients was 76.6 weeks (95% CI 65.4-87.8 weeks). Progression free survival for all patients measured 29.6 weeks (95% CI 24.4-34.7 weeks). One year overall survival was 68% and 2 year overall survival was 20%. Major treatment toxicities included grade 3/4 neutropenia and thrombocytopenia in 74 and 33% of treatment cycles, respectively. One patient died due to sepsis. These promising results are consistent with continued clinical investigation; a phase III clinical trial with whole body hyperthermia as the independent variable has been initiated.
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Affiliation(s)
- A Bakhshandeh
- Medical University of Lübeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
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