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Published in: Cancer Chemotherapy and Pharmacology 1/2008

01-12-2008 | Original Article

Gemcitabine at fixed dose-rate in patients with advanced soft tissue sarcomas: a mono-institutional phase II study

Authors: Virginia Ferraresi, Mariangela Ciccarese, Maria Cecilia Cercato, Carmen Nuzzo, Massimo Zeuli, Franco Di Filippo, Diana Giannarelli, Francesco Cognetti

Published in: Cancer Chemotherapy and Pharmacology | Issue 1/2008

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Abstract

Purpose

To explore the clinical activity and toxicity of gemcitabine infused at the fixed dose of 10 mg/m2/min over 100 min in patients with soft tissue sarcomas (STSs).

Patients and methods

Fourteen patients with advanced locally unresectable and/or metastatic, pretreated STSs (seven leiomyosarcoma, three malignant schwannoma, one synovialsarcoma, one malignant fibrous histiocytoma, one endometrial stromal cell sarcoma, one undifferentiated) were treated with gemcitabine 10 mg/m2/min/week over 100 min given for 3 weeks out of 4. The median age was 52 years (range 27–77), male/female ratio was 3/11, and the median WHO performance status was 0 (range 0–1). The median number of previous medical treatments for advanced disease was 1 (range 1–2).

Results

A median number of three cycles (range 1–10 cycles) and a total of 151 weekly administrations (median 9, range 3–27) of gemcitabine were administered. Treatment was well tolerated and the main causes of dose-reduction or omission/delay were hematological and liver toxicities. One patient (7%; 95% confidence interval: 0.2–33.9%) with a metastatic uterine leiomyosarcoma obtained a partial response that lasted for 6.5 months. Three patients (two leiomyosarcoma and one schwannoma) (21%) obtained a stabilization of disease. The median time to progression was 3.1 months (range 1.0–9.5). The median overall survival was 11.8 months (range 1.0–54.5+).

Conclusions

Gemcitabine infused at the fixed dose of 10 mg/m2/min over 100 min shows a good tolerability but an overall modest activity in unselected STSs histotypes. Nevertheless, an interesting tumor growth control rate was observed in specific histological variants (i.e., leiomyosarcoma), thus confirming data from recent controlled clinical trials.
Literature
1.
2.
go back to reference Spira AI, Ettinger DS (2002) The use of chemotherapy in soft-tissue sarcomas. Oncologist 7:348–359PubMedCrossRef Spira AI, Ettinger DS (2002) The use of chemotherapy in soft-tissue sarcomas. Oncologist 7:348–359PubMedCrossRef
3.
go back to reference Plunkett W, Huang P, Xu YZ, Heinemann V, Grunewald R, Gandhi V (1995) Gemcitabine: metabolism, mechanism of action, and self-potentiation. Semin Oncol 22:3–10PubMed Plunkett W, Huang P, Xu YZ, Heinemann V, Grunewald R, Gandhi V (1995) Gemcitabine: metabolism, mechanism of action, and self-potentiation. Semin Oncol 22:3–10PubMed
4.
go back to reference Merimsky O, Meller I, Flusser G et al (2000) Gemcitabine in soft tissue or bone sarcoma resistant to standard chemotherapy: a phase II study. Cancer Chemother Pharmacol 45:177–181PubMedCrossRef Merimsky O, Meller I, Flusser G et al (2000) Gemcitabine in soft tissue or bone sarcoma resistant to standard chemotherapy: a phase II study. Cancer Chemother Pharmacol 45:177–181PubMedCrossRef
5.
go back to reference Späth-Schwalbe E, Genvresse I, Koschuth A, Dietzmann A, Grunewald R, Possinger K (2000) Phase II trial of gemcitabine in patients with pretreated advanced soft tissue sarcomas. Anticancer Drugs 11:325–329PubMedCrossRef Späth-Schwalbe E, Genvresse I, Koschuth A, Dietzmann A, Grunewald R, Possinger K (2000) Phase II trial of gemcitabine in patients with pretreated advanced soft tissue sarcomas. Anticancer Drugs 11:325–329PubMedCrossRef
6.
go back to reference Patel SR, Gandhi V, Jenkins J et al (2001) Phase II clinical investigation of gemcitabine in advanced soft tissue sarcomas and window evaluation of dose rate on gemcitabine triphosphate accumulation. J Clin Oncol 19:3483–3489PubMed Patel SR, Gandhi V, Jenkins J et al (2001) Phase II clinical investigation of gemcitabine in advanced soft tissue sarcomas and window evaluation of dose rate on gemcitabine triphosphate accumulation. J Clin Oncol 19:3483–3489PubMed
7.
go back to reference Samuels BL, Barbour L, Schiller D (2001) Phase I study of low dose continuous infusion gemcitabine in sarcoma patients [abstract]. Proc Am Soc Clin Oncol 20:2935 Samuels BL, Barbour L, Schiller D (2001) Phase I study of low dose continuous infusion gemcitabine in sarcoma patients [abstract]. Proc Am Soc Clin Oncol 20:2935
8.
go back to reference Bauer S, Hartung J, Gauler T et al (2002) Gemcitabine-containing chemotherapy in the treatment of patients with advanced soft tissue sarcoma. Tumordiagn Ther 23:219–224CrossRef Bauer S, Hartung J, Gauler T et al (2002) Gemcitabine-containing chemotherapy in the treatment of patients with advanced soft tissue sarcoma. Tumordiagn Ther 23:219–224CrossRef
9.
go back to reference Look KY, Sandler A, Blessing JA, Lucci III JA, Rose PG (2004) Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a Gynecologic Oncology Group (GOG) Study. Gynecol Oncol 92:644–647PubMedCrossRef Look KY, Sandler A, Blessing JA, Lucci III JA, Rose PG (2004) Phase II trial of gemcitabine as second-line chemotherapy of uterine leiomyosarcoma: a Gynecologic Oncology Group (GOG) Study. Gynecol Oncol 92:644–647PubMedCrossRef
10.
go back to reference Abbruzzese JL, Grunewald R, Weeks EA et al (1991) A phase I clinical, plasma and cellular pharmacology study of gemcitabine. J Clin Oncol 9:491–498PubMed Abbruzzese JL, Grunewald R, Weeks EA et al (1991) A phase I clinical, plasma and cellular pharmacology study of gemcitabine. J Clin Oncol 9:491–498PubMed
11.
go back to reference Pollera CF, Ceribelli A, Crecco M, Calabresi F (1994) Weekly gemcitabine in advanced or metastatic solid tumors. A clinical phase I study. Invest New Drugs 12:111–119PubMedCrossRef Pollera CF, Ceribelli A, Crecco M, Calabresi F (1994) Weekly gemcitabine in advanced or metastatic solid tumors. A clinical phase I study. Invest New Drugs 12:111–119PubMedCrossRef
12.
go back to reference Grunewald R, Kantarjian H, Keating MJ, Abbruzzese J, Tarassoff P, Plunkett W (1990) Pharmacologically directed design of the dose rate and schedule of 2′,2′-difluorodeoxycytidine (gemcitabine) administration in leukemia. Cancer Res 50:6823–6826PubMed Grunewald R, Kantarjian H, Keating MJ, Abbruzzese J, Tarassoff P, Plunkett W (1990) Pharmacologically directed design of the dose rate and schedule of 2′,2′-difluorodeoxycytidine (gemcitabine) administration in leukemia. Cancer Res 50:6823–6826PubMed
14.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216PubMedCrossRef
15.
go back to reference Fleming TR (1982) One-sample multiple testing procedure for phase II clinical trials. Biometrics 38:143–151PubMedCrossRef Fleming TR (1982) One-sample multiple testing procedure for phase II clinical trials. Biometrics 38:143–151PubMedCrossRef
16.
go back to reference Touroutoglou N, Gravel D, Rabel MN, Plunkett W, Abbruzzese JL (1998) Clinical results of a pharmacodynamically-based strategy for higher dosing of gemcitabine in patients with solid tumors. Ann Oncol 9:1003–1008PubMedCrossRef Touroutoglou N, Gravel D, Rabel MN, Plunkett W, Abbruzzese JL (1998) Clinical results of a pharmacodynamically-based strategy for higher dosing of gemcitabine in patients with solid tumors. Ann Oncol 9:1003–1008PubMedCrossRef
17.
go back to reference Brand R, Capadano M, Tempero M (1997) A phase I trial of weekly gemcitabine administered as a prolonged infusion in patients with pancreatic cancer and other solid tumors. Invest New Drugs 15:331–341PubMedCrossRef Brand R, Capadano M, Tempero M (1997) A phase I trial of weekly gemcitabine administered as a prolonged infusion in patients with pancreatic cancer and other solid tumors. Invest New Drugs 15:331–341PubMedCrossRef
18.
go back to reference Amodio A, Carpano S, Manfredi C et al (1999) Gemcitabine in advanced soft tissue sarcoma: a phase II study. Clin Ter 150:17–20PubMed Amodio A, Carpano S, Manfredi C et al (1999) Gemcitabine in advanced soft tissue sarcoma: a phase II study. Clin Ter 150:17–20PubMed
19.
go back to reference Gautam U, Hurley J, Silva OE, Benedetto PW, Robles C (2002) Gemcitabine: an active chemotherapeutic agent for angiosarcoma [abstract]. Proc Am Soc Clin Oncol 21:2931 Gautam U, Hurley J, Silva OE, Benedetto PW, Robles C (2002) Gemcitabine: an active chemotherapeutic agent for angiosarcoma [abstract]. Proc Am Soc Clin Oncol 21:2931
20.
go back to reference Okuno S, Edmonson J, Mahoney M, Buckner JC, Frytak S, Galanis E (2002) Phase II trial of gemcitabine in advanced sarcomas. Cancer 94:3225–3229PubMedCrossRef Okuno S, Edmonson J, Mahoney M, Buckner JC, Frytak S, Galanis E (2002) Phase II trial of gemcitabine in advanced sarcomas. Cancer 94:3225–3229PubMedCrossRef
21.
go back to reference Švancárová L, Blay JY, Judson IR et al (2002) Gemcitabine in advanced adult soft-tissue sarcomas. A phase II study of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer 38:556–559PubMedCrossRef Švancárová L, Blay JY, Judson IR et al (2002) Gemcitabine in advanced adult soft-tissue sarcomas. A phase II study of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer 38:556–559PubMedCrossRef
22.
go back to reference Okuno S, Ryan LM, Edmonson JH, Priebat DA, Blum RH (2003) Phase II trial of gemcitabine in patients with advanced sarcomas (E1797). A trial of the Eastern Cooperative Oncology Group. Cancer 97:1969–1973PubMedCrossRef Okuno S, Ryan LM, Edmonson JH, Priebat DA, Blum RH (2003) Phase II trial of gemcitabine in patients with advanced sarcomas (E1797). A trial of the Eastern Cooperative Oncology Group. Cancer 97:1969–1973PubMedCrossRef
23.
go back to reference Hartmann JT, Oechsle K, Huober J et al (2006) An open label, non comparative phase II study of gemcitabine as salvage treatment for patients with pretreated adult type soft tissue sarcoma. Invest New Drugs 24:249–253PubMedCrossRef Hartmann JT, Oechsle K, Huober J et al (2006) An open label, non comparative phase II study of gemcitabine as salvage treatment for patients with pretreated adult type soft tissue sarcoma. Invest New Drugs 24:249–253PubMedCrossRef
24.
go back to reference Von Burton G, Rankin C, Zalupski MM, Mills GM, Borden EC, Karen A (2006) Phase II trial of gemcitabine as first line chemotherapy in patients with metastatic or unresectable soft tissue sarcoma. Am J Clin Oncol 29:59–61CrossRef Von Burton G, Rankin C, Zalupski MM, Mills GM, Borden EC, Karen A (2006) Phase II trial of gemcitabine as first line chemotherapy in patients with metastatic or unresectable soft tissue sarcoma. Am J Clin Oncol 29:59–61CrossRef
25.
go back to reference Hensley ML, Maki R, Venkatraman E et al (2002) Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 20:2824–2831PubMedCrossRef Hensley ML, Maki R, Venkatraman E et al (2002) Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 20:2824–2831PubMedCrossRef
26.
go back to reference Maki RG, Wathen JK, Patel SR et al (2007) Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of Sarcoma Alliance for Research through collaboration study 002 (corrected). J Clin Oncol 25:2755–2763PubMedCrossRef Maki RG, Wathen JK, Patel SR et al (2007) Randomized phase II study of gemcitabine and docetaxel compared with gemcitabine alone in patients with metastatic soft tissue sarcomas: results of Sarcoma Alliance for Research through collaboration study 002 (corrected). J Clin Oncol 25:2755–2763PubMedCrossRef
27.
go back to reference Buesa JM, Losa R, Fernández A et al (2004) Phase I clinical trial of fixed-dose rate infusional gemcitabine and dacarbazine in the treatment of advanced soft tissue sarcoma, with assessment of gemcitabine triphosphate accumulation. Cancer 101:2261–2269PubMedCrossRef Buesa JM, Losa R, Fernández A et al (2004) Phase I clinical trial of fixed-dose rate infusional gemcitabine and dacarbazine in the treatment of advanced soft tissue sarcoma, with assessment of gemcitabine triphosphate accumulation. Cancer 101:2261–2269PubMedCrossRef
28.
go back to reference Losa R, Fra J, López-Pousa A et al (2007) Phase II study with the combination of gemcitabine and DTIC in patients with advanced soft tissue sarcomas. Cancer Chemother Pharmacol 59:251–259PubMedCrossRef Losa R, Fra J, López-Pousa A et al (2007) Phase II study with the combination of gemcitabine and DTIC in patients with advanced soft tissue sarcomas. Cancer Chemother Pharmacol 59:251–259PubMedCrossRef
29.
go back to reference López-Pousa A, Losa R, Martin J et al (2006) Phase I/II trial of doxorubicin and fixed dose-rate infusion gemcitabine in advanced soft tissue sarcomas: a GEIS study. Br J Cancer 94:1797–1802PubMedCrossRef López-Pousa A, Losa R, Martin J et al (2006) Phase I/II trial of doxorubicin and fixed dose-rate infusion gemcitabine in advanced soft tissue sarcomas: a GEIS study. Br J Cancer 94:1797–1802PubMedCrossRef
30.
go back to reference Dileo P, Morgan JA, Zahrieh D et al (2007) Gemcitabine and vinorelbine combination chemotherapy for patients with advanced soft tissue sarcomas: results of a phase II trial. Cancer 109:1863–1869PubMedCrossRef Dileo P, Morgan JA, Zahrieh D et al (2007) Gemcitabine and vinorelbine combination chemotherapy for patients with advanced soft tissue sarcomas: results of a phase II trial. Cancer 109:1863–1869PubMedCrossRef
31.
go back to reference Xu N, Shen P, Zhang XC et al (2007) Phase II trial of a 2-h infusion of gemcitabine plus carboplatin as first-line chemotherapy for advanced non-small-cell lung cancer. Cancer Chemother Pharmacol 59:1–7PubMedCrossRef Xu N, Shen P, Zhang XC et al (2007) Phase II trial of a 2-h infusion of gemcitabine plus carboplatin as first-line chemotherapy for advanced non-small-cell lung cancer. Cancer Chemother Pharmacol 59:1–7PubMedCrossRef
32.
go back to reference Pereira JR, Fein L, Del Giglio A et al (2007) Gemcitabine administered as a short infusion versus a fixed dose rate in combination with cisplatin for the treatment of patients with advanced non-small cell lung cancer. Lung Cancer 58:80–87PubMedCrossRef Pereira JR, Fein L, Del Giglio A et al (2007) Gemcitabine administered as a short infusion versus a fixed dose rate in combination with cisplatin for the treatment of patients with advanced non-small cell lung cancer. Lung Cancer 58:80–87PubMedCrossRef
33.
go back to reference Kim H, Park JH, Shin SJ et al (2008) Fixed dose rate infusion of gemcitabine with oral doxifluridine and leucovorin for advanced unresectable pancreatic cancer: a phase II study. Chemotherapy 54:54–62PubMedCrossRef Kim H, Park JH, Shin SJ et al (2008) Fixed dose rate infusion of gemcitabine with oral doxifluridine and leucovorin for advanced unresectable pancreatic cancer: a phase II study. Chemotherapy 54:54–62PubMedCrossRef
34.
go back to reference Sun W, Hewitt MR, Theobald MR, Hershock D, Haller DG (2007) A phase I study of fixed dose rate gemcitabine and irinotecan in patients with advanced pancreatic and biliary cancer. Cancer 110:2768–2774PubMedCrossRef Sun W, Hewitt MR, Theobald MR, Hershock D, Haller DG (2007) A phase I study of fixed dose rate gemcitabine and irinotecan in patients with advanced pancreatic and biliary cancer. Cancer 110:2768–2774PubMedCrossRef
35.
go back to reference Philips GK, Halabi S, Sanford BL, Bajorin D, Small EJ; Cancer, Leukemia Group B (2008) A phase II trial of cisplatin, fixed dose-rate gemcitabine and gefitinib for advanced urothelial tract carcinoma: results of the Cancer and Leukaemia Group B 90102. BJU Int 101:20–25 Philips GK, Halabi S, Sanford BL, Bajorin D, Small EJ; Cancer, Leukemia Group B (2008) A phase II trial of cisplatin, fixed dose-rate gemcitabine and gefitinib for advanced urothelial tract carcinoma: results of the Cancer and Leukaemia Group B 90102. BJU Int 101:20–25
Metadata
Title
Gemcitabine at fixed dose-rate in patients with advanced soft tissue sarcomas: a mono-institutional phase II study
Authors
Virginia Ferraresi
Mariangela Ciccarese
Maria Cecilia Cercato
Carmen Nuzzo
Massimo Zeuli
Franco Di Filippo
Diana Giannarelli
Francesco Cognetti
Publication date
01-12-2008
Publisher
Springer-Verlag
Published in
Cancer Chemotherapy and Pharmacology / Issue 1/2008
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-008-0723-9

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