A dose escalation trial of biweekly docetaxel and gemcitabine with filgrastim or pegfilgrastim for the treatment of patients with advanced solid tumors.

Abstract:

BACKGROUND/AIMS:A single-institution phase I trial to determine the feasibility of using filgrastim or pegfilgrastim to increase the dose intensity of biweekly docetaxel and gemcitabine. METHODS:Patients with metastatic solid tumors received gemcitabine 3,000 mg/m(2) and increasing doses of docetaxel (55 mg/m(2) in 10 mg/m(2) increments) every 14 days with filgrastim or pegfilgrastim. RESULTS:35 patients enrolled, median 2 prior therapies, 158 cycles of therapy. There was 1 dose-limiting toxicity (DLT) (sepsis) at docetaxel 55 mg/m(2), 1 DLT (sepsis/diarrhea) at docetaxel 65 mg/m(2), and no DLT at docetaxel 75 mg/m(2). At docetaxel 85 mg/m(2), 2/4 patients had DLT (fatigue/dyspnea, diarrhea). The maximum tolerated dose (MTD) of docetaxel was 75 mg/m(2). 1/12 patients treated at MTD experienced DLT (sepsis/dyspnea). The initial 25 patients received filgrastim (average 7 doses/cycle), the last 10 received pegfilgrastim. CONCLUSIONS:The MTD for docetaxel was 75 mg/m(2) with gemcitabine 3,000 mg/m(2) given every 14 days with filgrastim or pegfilgrastim. This regimen was well tolerated with signs of clinical activity. We found no significant differences in toxicities or effectiveness between daily filgrastim and pegfilgrastim given 13 days before the next chemotherapy. The use of granulocyte growth factors allowed increased dose intensity of docetaxel and gemcitabine. This regimen warrants further study in chemotherapy-naïve patients and patients with earlier stages.

journal_name

Chemotherapy

journal_title

Chemotherapy

authors

Dragnev KH,Hardin SB,Pipas JM,Davis TH,Rigas JR

doi

10.1159/000313526

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

135-41

issue

2

eissn

0009-3157

issn

1421-9794

pii

000313526

journal_volume

56

pub_type

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