1
|
Takiguchi Y, Moriya T, Asaka-Amano Y, Kawashima T, Kurosu K, Tada Y, Nagao K, Kuriyama T. Phase II study of weekly irinotecan and cisplatin for refractory or recurrent non-small cell lung cancer. Lung Cancer 2007; 58:253-9. [PMID: 17658654 DOI: 10.1016/j.lungcan.2007.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 06/04/2007] [Accepted: 06/11/2007] [Indexed: 11/20/2022]
Abstract
Even with the standard first-line chemotherapy, advanced non-small cell lung cancer (NSCLC) recurs in most cases. The purpose of this study is to develop a new chemotherapeutic regimen for patients with NSCLC that has relapsed or was refractory to previous chemotherapy. Patients with proven NSCLC refractory or recurrent after previous single-regimen chemotherapy, PS of 0-2, age of 15 years or older, adequate organ functions and measurable lesions were treated with irinotecan at 60 mg/m(2) and cisplatin at 25 mg/m(2) with 1000 ml hydration on day 1. This administration, considered as one cycle, was repeated every week without rest unless encountering defined skip and dose-reduction criteria. The treatment was administered for six cycles over a 49-day period, both median values, to 48 patients, with a response rate of 26%, progression free and median survival times of 3 and 11 months, respectively, and a 1-year survival rate of 46%. The most frequent grade 3 or 4 toxicities were neutropenia, anaemia and nausea, which were manageable. Subset analyses suggested that the response rate was independent of response to the first-line chemotherapy. In conclusion, second-line chemotherapy of weekly irinotecan and cisplatin with minimum hydration seemed effective, with tolerable toxicity, and is potentially useful irrespective of the outcome of previous chemotherapy.
Collapse
Affiliation(s)
- Yuichi Takiguchi
- Department of Respirology (B2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Yatomi M, Takiguchi Y, Asaka-Amano Y, Arai M, Tada Y, Kurosu K, Sakao S, Kasahara Y, Tanabe N, Tatsumi K, Seki N, Kuriyama T. Altered gene expression by cisplatin in a human squamous cell lung carcinoma cell line. Anticancer Res 2007; 27:3235-3243. [PMID: 17970066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Substantial evidence has disclosed that some cytotoxic agents have complex activities in influencing signal transduction pathways in cells. MATERIALS AND METHODS cDNA microarray analysis was performed after exposing a human squamous cell carcinoma cell line, RERF-LC-AI, to low-dose cisplatin for 5 days. Up-regulated gene expressions were suppressed by small interfering RNA to investigate phenotypic alteration of the cells. RESULTS Among 30,000 genes screened, 42 genes showed increases or decreases in expression of more than 2-fold with cisplatin treatment. They included genes with functions involved in apoptosis, cell cycle regulation and DNA metabolism/repair. Suppression of the 5 most significantly altered genes by small interfering RNA resulted in partly reduced apoptosis without altering cytotoxicity of cisplatin. CONCLUSION Besides direct cytotoxic effects on cells, cisplatin may have indirect effects involving drug resistance, and synergistic effects with other agents.
Collapse
Affiliation(s)
- Mari Yatomi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Asaka-Amano Y, Takiguchi Y, Yatomi M, Kurosu K, Kasahara Y, Tanabe N, Tatsumi K, Kuriyama T. Effect of treatment schedule on the interaction of Cisplatin and radiation in human lung cancer cells. Radiat Res 2007; 167:637-44. [PMID: 17523845 DOI: 10.1667/rr0739.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Accepted: 01/02/2007] [Indexed: 11/03/2022]
Abstract
This study was designed to determine the effects of the treatment schedule on the interaction between cisplatin and radiation. Cells of a human squamous cell lung cancer cell line were treated with cisplatin and radiation using three treatment protocols: 1-h exposure to cisplatin immediately followed by irradiation (A), 4-day continuous exposure to cisplatin immediately followed by irradiation (B), and 1-h exposure to cisplatin followed by irradiation after a 4-day interval (C). The interactions were assessed by isobologram, cell cycle distribution and apoptosis. The combination resulted in a additive effect in every protocol. Cell cycle accumulation at G(2)/M phase before irradiation was observed in Protocols B and C, whereas no cell cycle shift in the limited time course was noted in Protocol A. Although a 4-day continuous exposure to cisplatin and a 1-h exposure to cisplatin followed by a 4-day interval before irradiation caused significantly increased apoptosis, an additional increase in apoptosis after irradiation was not observed in Protocols B and C, whereas Protocol A showed an additional increase. Despite a cell cycle shift favoring radiation sensitivity, the drug-radiation interactions in Protocols B and C were additive, possibly because of negative effects including induction of a durable G(2)/M-phase arrest and suppression of apoptosis by cisplatin.
Collapse
Affiliation(s)
- Yoshiko Asaka-Amano
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Onoda S, Masuda N, Seto T, Eguchi K, Takiguchi Y, Isobe H, Okamoto H, Ogura T, Yokoyama A, Seki N, Asaka-Amano Y, Harada M, Tagawa A, Kunikane H, Yokoba M, Uematsu K, Kuriyama T, Kuroiwa Y, Watanabe K. Phase II Trial of Amrubicin for Treatment of Refractory or Relapsed Small-Cell Lung Cancer: Thoracic Oncology Research Group Study 0301. J Clin Oncol 2006; 24:5448-53. [PMID: 17135647 DOI: 10.1200/jco.2006.08.4145] [Citation(s) in RCA: 184] [Impact Index Per Article: 10.2] [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: 11/20/2022] Open
Abstract
Purpose This multicenter, phase II study was conducted to evaluate the activity of amrubicin, a topoisomerase II inhibitor, against refractory or relapsed small-cell lung cancer (SCLC). Patients and Methods SCLC patients with measurable disease who had been treated previously with at least one platinum-based chemotherapy regimen and had an Eastern Cooperative Oncology Group performance status of 0 to 2 were eligible. Two groups of patients were selected: patients who experienced first-line treatment failure less than 60 days from treatment discontinuation (refractory group), and patients who responded to first-line treatment and experienced disease progression ≥ 60 days after treatment discontinuation (sensitive group). Amrubicin was administered as a 5-minute daily intravenous injection at a dose of 40 mg/m2 for 3 consecutive days, every 3 weeks. Results Between June 2003 and December 2004, 60 patients (16 refractory and 44 sensitive) were enrolled. The median number of treatment cycles was four (range, one to eight). Grade 3 or 4 hematologic toxicities comprised neutropenia (83%), thrombocytopenia (20%), and anemia (33%). Febrile neutropenia was observed in three patients (5%). Nonhematologic toxicities were mild. No treatment-related death was observed. The overall response rates were 50% (95% CI, 25% to 75%) in the refractory group, and 52% (95% CI, 37% to 68%) in the sensitive group. The progression-free survival, overall survival, and 1-year survival in the refractory group and the sensitive group were 2.6 and 4.2 months, 10.3 and 11.6 months, and 40% and 46%, respectively. Conclusion Amrubicin exhibits significant activity against SCLC, with predictable and manageable toxicities; this agent deserves to be studied more extensively in additional trials.
Collapse
Affiliation(s)
- Sayaka Onoda
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Takiguchi Y, Asaka-Amano Y, Moriya T, Kawashima T, Mizoo A, Kurosu K, Nagao K, Kuriyama T. Phase II study of weekly irinotecan and cisplatin for refractory or recurrent non-small cell lung cancer (NSCLC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.17002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
17002 Background: A current option for recurrent NSCLC is monotherapy with docetaxel. However, cisplatin, if tolerable, may still have power for this condition. Irinotecan is also a key drug for NSCLC. The objectives of this study were to evaluate the clinical relevance of weekly chemotherapy consisting of irinotecan and cisplatin as a 2nd-line therapy for NSCLC. Methods: Patients meeting all following criteria were eligible: proven NSCLC refractory or recurrent after previous single-regimen chemotherapy, PS (0–2), age > 15 years, adequate organ functions, measurable lesions by RECIST, life expectancy exceeding 8 weeks, and written informed consent. Patients with any of the following conditions were ineligible: previous treatment with irinotecan and/or surgery, requirement of thoracic irradiation, interstitial lung disease, pleural effusion or ascites requiring treatment, pericardial effusion, symptomatic brain metastasis, concomitant malignancy or other inadequate condition. Irinotecan (60 mg/m2 in 500 ml electrolyte soln, day 1) and cisplatin (25 mg/m2 in 500 ml saline, day 1, without further hydration) were administered every week for at least 6 courses unless encountering defined skip criteria. Calculated minimum sample size was 43 based on Simon two-stage optimal design with p0=0.10, p1=0.25, α error=0.05 and β error=0.20; planned sample size was 48. The primary endpoint was response rate, and the secondary ones were toxicity and survival time. Results: Since February 2002, 48 patients (consisting of 29 with adeno-, 14 with squamous cell, 3 with large cell carcinoma and 2 with NSCLC not further specified) with a median age of 62-years were enrolled, with 1 death before treatment. Therefore, 47 patients were eligible for evaluation of response rate and toxicity, whereas all 48 were analyzed for survival. Chemotherapy was administered for a median 6 courses (range, 0–15). Response rate was 25.5% (95% CI: 12.9–38.1%). Toxicity of grade 3 or 4 consisted of neutropenia (29.8%), thrombocytopenia (6.4%), anemia (29.8%), diarrhea (10.6%) and nausea (21.3%). MST was 10.6 months, and 1-year survival rate was 43%. Conclusions: This 2nd-line chemotherapy for NSCLC showed promising efficacy with tolerable toxicity. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- Y. Takiguchi
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - Y. Asaka-Amano
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - T. Moriya
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - T. Kawashima
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - A. Mizoo
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - K. Kurosu
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - K. Nagao
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| | - T. Kuriyama
- Chiba University Graduate School of Medicine, Chiba, Japan; Matsudo Hospital, Matsudo, Japan; Sakura Hospital, Sch of Medcn, Toho University, Sakura, Japan; Tokyo Kosei Nenkin Hospital, Tokyo, Japan; Chiba University, Chiba, Japan
| |
Collapse
|
6
|
Takiguchi Y, Uruma R, Asaka-Amano Y, Kurosu K, Kasahara Y, Tanabe N, Tatsumi K, Uno T, Itoh H, Kuriyama T. Phase I study of cisplatin and irinotecan combined with concurrent hyperfractionated accelerated thoracic radiotherapy for locally advanced non-small cell lung carcinoma. Int J Clin Oncol 2005; 10:418-24. [PMID: 16369746 DOI: 10.1007/s10147-005-0525-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Accepted: 08/01/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Irinotecan, when combined with cisplatin, is an effective treatment for advanced non-small cell lung cancer (NSCLC). This constitutes a rationale for conducting a phase I study of chemoradiotherapy including this combination for locally advanced NSCLC. PATIENTS AND METHODS Patients with locally advanced NSCLC and a performance status of 0 or 1 were eligible. The protocol consisted of escalating doses of irinotecan on days 1 and 15, and daily low-dose cisplatin (6 mg/m(2) daily for a total dose of 120 mg/m(2)) combined with concurrent hyperfractionated accelerated thoracic irradiation (1.5 Gy twice daily for a total dose of 60 Gy). RESULTS The maximum tolerable dose was 50 mg/m(2) of irinotecan, and the dose-limiting toxicity was esophagitis. Tumor response was observed in 50% of cases, and the median survival time of the 12 patients enrolled was 10.1 months, including two patients with 5-year disease-free survival. A pharmacokinetics study demonstrated an accumulation of total platinum, but not of free platinum, during the 26-day treatment period. CONCLUSION The recommended dose for phase II studies was determined.
Collapse
Affiliation(s)
- Yuichi Takiguchi
- Department of Respirology (B2), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Shingyoji M, Takiguchi Y, Watanabe-Uruma R, Asaka-Amano Y, Matsubara H, Kurosu K, Kasahara Y, Tanabe N, Tatsumi K, Kuriyama T. In vitro conversion of irinotecan to SN-38 in human plasma. Cancer Sci 2004; 95:537-40. [PMID: 15182436 DOI: 10.1111/j.1349-7006.2004.tb03245.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 11/29/2022] Open
Abstract
Irinotecan is an active cytotoxic agent for various cancers, and is converted to SN-38, its most active metabolite, by carboxylesterase converting enzyme (CCE) in vivo. Although the primary metabolic site is in the liver, ex vivo studies have proven that irinotecan is also converted to SN-38 in intestines, plasma and tumor tissues. The present study attempted to elucidate the in vitro conversion efficiency in human plasma, and to examine possible inter-individual variability and its clinical significance. Plasma samples were taken from 57 patients with lung cancer, 3 patients with benign pulmonary diseases and 9 healthy volunteers. After addition of 157 mM irinotecan to plasma, time courses of SN-38 concentration, measured by high-performance liquid chromatography (HPLC), were investigated. All subjects showed linear increase in SN-38 concentration during the first 60-min period, followed by a plateau. Mean and standard deviation of the conversion rate in the first 60 min were 515.9 +/- 50.1 pmol/ml/h (n = 69), with a coefficient of variation of 0.097. Although most of the subjects showed comparable conversion rates, 3 subjects had significantly higher conversion rates. In conclusion, the results of this study suggest that the enzyme activity of CCE in human plasma may show inter-individual variability.
Collapse
Affiliation(s)
- Masato Shingyoji
- Department of Respirology (B2), Graduate School of Medicine, Chiba University, Chuo-ku, Chiba 260-8670
| | | | | | | | | | | | | | | | | | | |
Collapse
|