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Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Challenges in advanced NSCLC: optimizing platinum-based chemotherapy and treating special populations
1Lung and Thoracic Cancer Program, University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. belanicp@upmc.edu
Journal of the National Comprehensive Cancer Network : JNCCN
|September 29, 2009
Summary
Carboplatin-based chemotherapy shows promise for elderly and performance status 2 non-small cell lung cancer patients. Weekly paclitaxel with monthly carboplatin may improve tolerability and efficacy.
Area of Science:
- Medical Oncology
- Clinical Pharmacology
Background:
- Platinum-based chemotherapy is standard for advanced non-small cell lung cancer (NSCLC).
- Elderly patients and those with performance status 2 (PS2) face challenges with standard regimens due to tolerability concerns.
- Carboplatin offers a better tolerability profile than cisplatin with comparable efficacy, making carboplatin-based regimens a community standard.
Purpose of the Study:
- To review the evidence for platinum-based chemotherapy in elderly and PS2 patients with advanced NSCLC.
- To explore the efficacy and tolerability of carboplatin-based regimens in these specific patient populations.
- To discuss optimal administration schedules for carboplatin and paclitaxel.
Main Methods:
- Review of recent clinical evidence and trial data concerning NSCLC treatment in elderly and PS2 patients.
- Analysis of comparative efficacy and tolerability of different platinum-based chemotherapy regimens.
- Discussion of findings from Phase II trials on weekly paclitaxel plus monthly carboplatin.
Main Results:
- "Fit" elderly patients demonstrate good response to platinum-based doublet therapy.
- Carboplatin-based doublets show greater efficacy than single-agent paclitaxel in PS2 patients.
- Phase II trials suggest weekly paclitaxel with monthly carboplatin may enhance tolerability and efficacy compared to standard schedules.
Conclusions:
- Carboplatin-based doublets are effective for selected elderly and PS2 patients with advanced NSCLC.
- Weekly paclitaxel plus monthly carboplatin warrants further investigation for optimal treatment of these populations.
- Further evidence from completed Phase III trials is anticipated to guide clinical decisions.
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