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Lung Cancer (Amsterdam, Netherlands) Dec 2005This evidence-based practice guideline on the use of paclitaxel (Taxol) or docetaxel (Taxotere) as first-line treatment for patients with advanced non-small cell lung... (Review)
Review
UNLABELLED
This evidence-based practice guideline on the use of paclitaxel (Taxol) or docetaxel (Taxotere) as first-line treatment for patients with advanced non-small cell lung cancer who are candidates for palliative first-line chemotherapy is based on a systematic search and review of literature published in full or in abstract form between 1985 and April 2005. Forty-five randomized trials, including 11 abstracts, were reviewed and clinicians in the province of Ontario, Canada, provided feedback on a draft version of the guideline. Two phase III trials detected a statistically significant survival advantage for a taxane (paclitaxel or docetaxel) with best supportive care versus best supportive care alone. Among the nine fully published phase III trials comparing platinum-based chemotherapies, taxane-platinum combinations achieved higher response rates compared with older chemotherapy combinations, although significantly longer survival was observed only for docetaxel-cisplatin compared with vindesine-cisplatin. Response rates and survival were generally not significantly different for taxane-platinum combinations compared with other current chemotherapy combinations, although the toxicity profile of the regimens varied. However, in one large trial, improved tumor response and modest survival and quality of life benefits were associated with docetaxel-cisplatin compared with vinorelbine-cisplatin. No statistically significant survival differences were detected in the three fully published phase III trials comparing a taxane-gemcitabine combination with a taxane-platinum regimen.
RECOMMENDATIONS
(i) paclitaxel or docetaxel combined with cisplatin is recommended as one of a number of chemotherapy options for the first-line treatment of advanced non-small cell lung cancer in patients with a good performance status; (ii) carboplatin may be combined with a taxane if a patient is unable or unwilling to take cisplatin; (iii) a taxane-gemcitabine combination may be considered for patients with a contraindication to cisplatin and carboplatin; (iv) no firm recommendation can be made on the optimal dose and schedule of taxane-based chemotherapy; however, commonly used regimens include cisplatin 75 mg/m2 combined with either docetaxel 75 mg/m2 or paclitaxel 135 mg/m2 (24-h infusion) and carboplatin AUC 6 combined with paclitaxel 225 mg/m2 (3-h infusion); (v) a single-agent taxane may be used if combination chemotherapy is considered inappropriate.
Topics: Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Carcinoma, Non-Small-Cell Lung; Cisplatin; Clinical Trials, Phase III as Topic; Docetaxel; Humans; Lung Neoplasms; Meta-Analysis as Topic; Paclitaxel; Randomized Controlled Trials as Topic; Taxoids
PubMed: 16139391
DOI: 10.1016/j.lungcan.2005.06.010 -
Cancer Nursing 2014The central nervous system is a unique sanctuary site for malignant disease. To ensure optimal disease control, intrathecal (IT) chemotherapy is commonly given in... (Review)
Review
BACKGROUND
The central nervous system is a unique sanctuary site for malignant disease. To ensure optimal disease control, intrathecal (IT) chemotherapy is commonly given in conjunction with standard chemotherapy protocols, thus providing the opportunity for medication errors.
OBJECTIVE
A systematic review of the current literature on medication errors associated with the administration of IT chemotherapy was conducted.
METHODS
English-language literature published from January 1960 through June 2013 was accessed. Case reports, clinical studies, and review articles pertaining to IT medication errors were included in the review. References of all relevant articles were searched for additional citations.
RESULTS
Twenty-two cases of accidental IT overdoses have been reported with methotrexate and 1 with cytarabine. There have been numerous cases of antineoplastic agents intended for administration by the parenteral route being inadvertently given intrathecally. Vincristine has been implicated 31 times (25 deaths), as well as vindesine, asparaginase, bortezomib, daunorubicin, and dactinomycin. This has led to profound toxicity and, commonly, death. Unfortunately, many cases go unrecognized or unreported.
CONCLUSIONS
The best method for eliminating the risk of IT medication errors is to develop effective methods of prevention and incorporate them into oncology and hematology practice internationally. Strategies include abolishing the syringe as a method of vinca alkaloid administration and substituting small-volume intravenous bags, and developing novel methods for intraspinal drug administration.
IMPLICATIONS FOR PRACTICE
The nursing profession is in a unique position to influence change and lead the way in establishing preventative strategies into current practice.
Topics: Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Cytarabine; Evidence-Based Medicine; Humans; Injections, Spinal; Medication Errors; Methotrexate; Vincristine
PubMed: 24201315
DOI: 10.1097/NCC.0000000000000108 -
Internal Medicine (Tokyo, Japan) 2012We report two cases of membranoproliferative glomerulonephritis, involved in Castleman's disease of hyaline vascular variant and mixed variant, respectively. The... (Review)
Review
We report two cases of membranoproliferative glomerulonephritis, involved in Castleman's disease of hyaline vascular variant and mixed variant, respectively. The diagnoses were confirmed by cervical lymph node and renal biopsy. Both cases were sensitive to chemotherapy with cyclophosphamide, vindesine and prednisone (COP). With the experience from treating case 1, which was misdiagnosed 9 years previously, we followed a more vigilant approach toward case 2 and achieved a more timely diagnosis. Finally, we reviewed pertinent literature of diagnosis and therapy to facilitate an early diagnosis of rare cases in the future.
Topics: Adult; Castleman Disease; Cyclophosphamide; Drug Therapy, Combination; Female; Glomerulonephritis, Membranoproliferative; Humans; Hyalin; Male; Middle Aged; Prednisone; Vindesine
PubMed: 22728487
DOI: 10.2169/internalmedicine.51.6298 -
Anticancer Research 1999We carried out a systematic review of new drugs active in non-small cell lung carcinoma (NSCLC). Fifty five phase II and III trials were reviewed (vinorelbine (19... (Review)
Review
We carried out a systematic review of new drugs active in non-small cell lung carcinoma (NSCLC). Fifty five phase II and III trials were reviewed (vinorelbine (19 trials), paclitaxel (15), gemcitabine (11), docetaxel (6), topotecan (2) or irinotecan (2)). The first four ones could be considered as active drugs when given as single agent. More information is required for the camptothecin derivatives. Four phase III randomised studies were available, all concerning vinorelbine. They showed that in combination with cisplatin, vinorelbine improved the response rate and perhaps survival, in comparison to vinorelbine alone and that vinorelbine was better than 5 fluorouracil and vindesine. A quantitative overview was impracticable, because of too few randomised trials. A qualitative overview was carried out using the European Lung Cancer Working Party score. The overall median quality score was 65.3%. There was no statistically significant difference between the drugs, but there was a positive correlation between the score and the number of patients. There was also an improvement of the quality score in favour of the randomised trials. Some important methodological aspects were often missing in the articles. In conclusion, gemcitabine, vinorelbine, paclitaxel and docetaxel are active against NSCLC but more good-quality data are required to define their exact role in the routine.
Topics: Antineoplastic Agents; Camptothecin; Carcinoma, Non-Small-Cell Lung; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Deoxycytidine; Docetaxel; Humans; Irinotecan; Lung Neoplasms; Paclitaxel; Randomized Controlled Trials as Topic; Taxoids; Topotecan; Vinblastine; Vinorelbine; Gemcitabine
PubMed: 10650780
DOI: No ID Found -
The Cochrane Database of Systematic... Jul 2009Human immunodeficiency virus (HIV) infection is known to be associated with an increased risk of non-Hodgkin's lymphoma (NHL). The majority of lymphomas (>80%) occurring... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Human immunodeficiency virus (HIV) infection is known to be associated with an increased risk of non-Hodgkin's lymphoma (NHL). The majority of lymphomas (>80%) occurring during immunosuppression are aggressive B-cell in origin and have a high-to-intermediate histology grade. Treatment of NHL is not standardized.
OBJECTIVES
To assess the clinical effectiveness and safety of single agent or combination chemotherapy with or without immunochemotherapy (rituximab) and with or without highly active antiretroviral therapy (HAART) on overall survival (OS) and disease-free survival (DFS) for previously untreated patients with AIDS-related NHL.
SEARCH STRATEGY
The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2009), MEDLINE (1966-March 6, 2009), EMBASE (1988-March 6, 2009), LlLACS (1982 to February 17, 2009), Gateway (March 6, 2009), and AIDSearch (2006 -February 2008) were used to identify published, potentially eligible trials. Further, we searched several electronic sources. For additional information see the Cochrane HIV/AIDS Group search strategy.
SELECTION CRITERIA
Randomized controlled trials (RCTs) assessing the effectiveness of systemic treatments for previously untreated AIDS-related NHL. There were no age or language restrictions.
DATA COLLECTION AND ANALYSIS
Authors independently assessed relevant studies for inclusion; four RCTs were selected. No meta-analysis was attempted due to clinical heterogeneity.
MAIN RESULTS
Four RCTs that included 857 patients (number range: 30 to 485) met the inclusion criteria. The studies have a high risk of bias; three RCTs were conducted in the United States and one was a multi-national, multi-centre RCT performed in France and Italy. One of the trials included only men. It was impossible to pool data for any of the outcomes due to the differences in the interventions assessed in these RCTs. Overall survival did not differ significantly between treatment groups. Disease free survival (DFS) was reported in two of the four RCTs, but it was not statistically significant between treatment groups.
AUTHORS' CONCLUSIONS
We found no evidence that the systemic interventions for untreated patients with AIDS-related NHL provide superior clinical effectiveness for improving OS, DSF, and tumour response rate; however, this conclusion is based on four RCTs with limited sample size and variable quality. More adequately powered RCTs that have low risk of bias are necessary to determine the real benefit or harm of interventions to treat this population. Overall survival (OS), DFS, and quality of life should be included as endpoints.
Topics: Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Combined Chemotherapy Protocols; Antiretroviral Therapy, Highly Active; Bleomycin; Cyclophosphamide; Dexamethasone; Disease-Free Survival; Doxorubicin; Female; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Leucovorin; Lymphoma, AIDS-Related; Male; Methotrexate; Prednisolone; Prednisone; Randomized Controlled Trials as Topic; Rituximab; Vincristine; Vindesine
PubMed: 19588373
DOI: 10.1002/14651858.CD005419.pub2 -
British Journal of Cancer May 2001In order to clarify the role of mitomycin (MMC) in the treatment of NSCLC, we performed a systematic review of the literature and qualitatively assessed the selected... (Meta-Analysis)
Meta-Analysis
In order to clarify the role of mitomycin (MMC) in the treatment of NSCLC, we performed a systematic review of the literature and qualitatively assessed the selected studies using the ELCWP and Chalmers scales. 5 trials (202 patients) assessed the activity of MMC as single-agent chemotherapy in NSCLC. The overall response rate was 25% (95% Cl 19-31). In 10 randomized phase III trials (1769 patients), we studied the role of MMC in combination therapy. A meta-analysis, based on the available published data, failed to show any survival advantage of the MMC containing regimens (hazard ratio = 0.95; 95% Cl 0.83-1.10). Finally, 4 eligible trials (139 patients) assessed the activity of MMC regimens as salvage therapy, 3 in combination with vindesine and one with cisplatin and vinblastine. The overall response rate for the MMC-vindesine regimen was 10.5% (95% Cl 1.7-19.4). In conclusion, MMC is an active drug for NSCLC but does not improve survival when combined with other active drugs, particularly cisplatin. Its use for salvage therapy appears to be associated with marginal activity only.
Topics: Antibiotics, Antineoplastic; Carcinoma, Non-Small-Cell Lung; Clinical Trials as Topic; Humans; Lung Neoplasms; Mitomycin; Salvage Therapy; Survival Analysis
PubMed: 11336463
DOI: 10.1054/bjoc.2001.1742