학술논문

Phase I study of high-dose topotecan with haematopoietic stem cell support in the treatment of ovarian carcinomas: the ITOV 01 protocol.
Document Type
Article
Source
Bone Marrow Transplantation. Apr2006, Vol. 37 Issue 7, p669-675. 7p. 4 Charts, 2 Graphs.
Subject
*CLINICAL trials
*HEMATOPOIETIC stem cells
*OVARIAN diseases
*TOXICITY testing
*SEPSIS
*DIARRHEA
Language
ISSN
0268-3369
Abstract
Topotecan has demonstrated activity in ovarian carcinomas. In order to increase the tumour response rate and to define the maximum tolerated dose (MTD) of topotecan, we decided to develop a high-dose phase I regimen supported by stem cell support. High-doses schedules using a 1-day single administration have MTDs of 10.5 (24 h continuous infusion (CI)) or 22.5 mg/m2 (30 min infusion). Five-day CI induces grade IV mucositis at high doses (MTD<12 mg/m2). We chose to administer topotecan in a 5-day schedule with a 30 min daily infusion. Patients were scheduled to receive one cycle of therapy. The first dose level was 4.0 mg/m2/day × 5 days. Limiting toxicities were defined as toxic death, grade IV non-haematopoietic or haematopoietic toxicity >6 weeks. From August 1998 to April 2002, 49 patients were included. Forty-three patients have completed one course and 15 have received two cycles. One patient treated at level 7 mg/m2/day died of sepsis. Median duration of grade IV neutropenia was 9 days. Two episodes of grade IV diarrhoea were observed at level 9.5 mg/m2/day. Pharmacokinetic data were linear within the dose range of 4–9.0 mg/m2/day. The MTD was reached at 9 mg/m2/day × 5 days.Bone Marrow Transplantation (2006) 37, 669–675. doi:10.1038/sj.bmt.1705310; published online 27 February 2006 [ABSTRACT FROM AUTHOR]