PubMed Health⌕ Search

Biomedical subjects

Oscar Juan

Publications and source records attributed to Oscar Juan.

7 recordsLinked to original sources
PubMed2005

Influence of the cyto-protective agent amifostine on the pharmacokinetics of low-dose Paclitaxel.

BACKGROUND: Pharmacokinetic parameters (PHK) of low-dose weekly paclitaxel (PAC) are not well known, particularly when administered with the cytoprotective agent amifostine (AMI). METHODS: Patients with non-small cell lung cancer (NSCLC) received PAC alone or PAC + AMI. Blood samples were drawn at the end of the infusion at 0, 0.25, 0.5, 1, 2 and 4 h for the measurement of plasma PAC using HPLC. Area under the concentration-time curve (AUC), the peak plasma concentrations (Cmax) and the residence time of paclitaxel in plasma at concentrations >0.1 microM (TPP >or=0.1) and >0.05 microM (TPP >or=0.05) were calculated using a two-compartmental model. ANOVA was used for statistical analysis. RESULTS: Pharmacokinetic studies were completed for 43 doses among 11 patients receiving PAC alone and for 26 doses among 8 patients receiving the combination AMI + PAC (from the first to the fifth week). Statistically significant differences in all parameters except AUC were observed between the 2 treatment groups. A significantly higher Cmax was observed for patients receiving PAC + AMI versus PAC alone. Both TPP >or=0.1 and TPP >or=0.05 were also more prolonged in AMI + PAC cycles. CONCLUSION: AMI produces a prolongation in PAC plasma circulation time. Further specifically designed studies are needed to quantify the resultant effects on PAC's efficacy and toxicity.

Amifostine↗
PubMed2003

Gemcitabine and carboplatin in advanced transitional cell carcinoma of the urinary tract: an alternative therapy.

BACKGROUND: Cisplatin-based combinations are considered to be the standard treatment for advanced transitional cell carcinoma (TCC) of the urothelium. Many of the patients are elderly with concomitant diseases or impaired renal function. We studied the tolerance and activity of the gemcitabine/carboplatin combination as a therapeutic alternative. METHODS: Patients with locally advanced or metastatic TCC of the urothelium were treated with gemcitabine 1000 mg/m(2) on Days 1 and 8 and carboplatin area under the concentration-time curve 5 on Day 1 every 21 days. Patients with creatinine clearance of 30 mL/min or above and Karnofsky performance status (KPS) scores 60 or above were enrolled. RESULTS: A total of 227 cycles were administered to 41 patients, with an average of 5.5 cycles per patient (range, 1-8 cycles). Creatinine clearance was below 60 mL/min in 54% of patients, KPS was 70 or below in 37% of patients, and 37% of patients were 70 years old or older. Hematologic toxicity was mainly Grade 3/4 neutropenia in 63%, Grade 3/4 thrombocytopenia in 32%, and Grade 3/4 anemia in 54% of patients. There were only three episodes of febrile neutropenia and one death from neutropenic sepsis. Nonhematologic toxicity was mild, with asthenia as the most frequently reported event. We obtained 6 complete and 17 partial responses, for an overall response rate of 56.1% (95% confidence interval [CI], 40.6-71.6%). Progression-free survival was 7.2 months (95% CI, 5.7-8.5) and median survival was 10.1 months (95% CI, 8.8-12.2). CONCLUSIONS: The combination of gemcitabine plus carboplatin achieves a similar result to doublets using cisplatin. It has an acceptable toxicity profile and enables patients with impaired renal function and/or poor performance status and elderly patients to be treated.

Aged↗
PubMed2002

Weekly paclitaxel in the treatment of metastatic and/or recurrent non-small cell lung cancer.

Weekly paclitaxel was initially used to exploit the radiosensitizing properties of the drug. However, the observed improvement in therapeutic index with this regimen encouraged further use of weekly regimens, with and without radiotherapy, as a single-agent or in combination with other regimens. Single-agent weekly paclitaxel, at doses ranging from 50 to 200 mg/m(2)/week, has been associated with response rates of 23-56% with acceptable toxicity. Weekly paclitaxel has also been combined with carboplatin and vinorelbine in two-drug combinations and with cisplatin plus gemcitabine and cisplatin plus vinorelbine in three-drug regimens. Response rates with weekly paclitaxel in combination chemotherapy have ranged from 16 to 71%. Paclitaxel is particularly suited to combined modality therapy with radiation in non-small cell lung cancer, because of its modest toxicity profile, significant antineoplastic activity, ease of administration and potential for radiosensitization. Studies of weekly paclitaxel given together with radiotherapy, with or without carboplatin, have produced response rates of 71-86% with median survival durations of 17-20.5 months.

Antineoplastic Agents, Phytogenic↗
PubMed2002

[Megestrol acetate: a systematic review usefulness about the weight gain in neoplastic patients with cachexia].

BACKGROUND: The clinical efficacy of megestrol acetate in the treatment of cachexia in cancer patients has not been clearly demonstrated. A systematic review and meta-analysis have been performed to ascertain its effectiveness on weight gain in patients with cancer-associated cachexia. MATERIAL AND METHOD: A systematic review of randomized clinical trials comparing megestrol acetate with placebo in cancer patients was performed. The outcome measure used was weight gain expressed as the difference in weight at the outset compared with that at the end of treatment. Trials analyzed were those that allowed for this calculation, or those whose authors provided information for the above calculation. RESULTS: Patients treated with placebo had an average weight loss of 1.090 kg (CI 95%, 1.620 to 0.561), whereas patients treated with megestrol acetate gained an average 0.423 kg (CI 95%, 0.078-0.769). A weight gain of 0.448 kg (CI 95%, 0.021-0.874) was observed with acetate megestrol doses # 240 mg. No statistically significant effect was observed when using higher doses: 0.358 kg (CI 95%, 0.135-0.85). CONCLUSIONS: Megestrol acetate doses equal to or lower than 240 mg/day lead to slight weight gain in patients with cancer-associated cachexia. The majority of studies have a low methodological quality. Further, well-designed studies comparing megestrol acetate with placebo are warranted.

Cachexia↗
PubMed2002

Low-dose weekly paclitaxel as second-line treatment for advanced non-small cell lung cancer: a phase II study.

PURPOSE: To assess the activity and toxicity of low-dose weekly paclitaxel in patients with non-resectable or metastatic non-small cell lung cancer (NSCLC) and who had disease recurrence or failure with previous chemotherapy. PATIENTS AND METHODS: Forty patients with NSCLC previously treated with platinum-based chemotherapy received weekly paclitaxel 80 mg/m(2) as a 1 h infusion. The median age was 63 years (range 42-77 years); 25 patients had Eastern Cooperative Oncology Group performance status (PS) 1 and 15 had PS 2. Thirty-one patients had stage IV disease and nine stage III (eight stage IIIB and one stage IIIA). RESULTS: A total of 364 weeks of treatment were administered (median 8 weeks, range 2-17 weeks). There were no episodes of grade 3 or 4 haematological toxicities. Severe non-haematological toxicity was uncommon: grade 1-2 asthenia in 50%; grade 1-2 motor neuropathy in 45% and grade 3 in 10%; grade 1-2 sensory neuropathy in 62% of patients. Alopecia was mild. The overall response rate was 37.5% (95% CI, 23.9-55): 2 CR, 13 PR, 15 SD, 8 PD, 2 NE. Median overall survival was 9.7 months (95% CI, 6.5-12.8). Median time to progression was 5.4 months (95% CI, 1.8-8.9). CONCLUSION: A low-dose weekly paclitaxel regimen had good clinical efficacy with low toxicity in this group of patients with poor prognosis. This regimen increases the therapeutic options available for second-line therapy in NSCLC patients.

Adult↗