Paclitaxel Gemcitabine

Four to six cycles of doublet chemotherapy with cisplatin or carboplatin plus docetaxel, gemcitabine, paclitaxel, or vinorelbine are recommended as first-line chemotherapy for patients with unresectable stage III or IV NSCLC. No combination was found to be superior tolerance of expected toxicities may contribute to the decision. 

Etoposide/cisplatin Vinorelbine/gemcitabine Paclitaxel/gemcitabine Gemcita bi ne/ docetaxel Paclitaxel/vinorelbine... 

Bellmunt J, Guillem V, Paz-Ares L, et al. Gemcitabine/paclitaxel-based three-drug regimens in advanced urothelial cancer. Eur J Cancer 2000 36 Suppl 2 17-25. 

Liu G, Bailey HH, Arzoomanian RZ, Alberti D, Binger K, Volkman J, Feierabend C, Marnocha R, Wilding G, Thomas JP. Gemcitabine, Paclitaxel, and Piritrexim a phase I study. Am J Clin Oncol 2003 26(3) 280. ... 

Paclitaxel 175 mg/m2 IV over 3 hours, day 1 Gemcitabine 1,250 mg/m2 IV days 1 and 8 Repeat cycles every 21 days... 

Chemotherapeutic agents that have significant cancer response when combined with hyperthermia (up to 43°C) include doxorubicin, melphalan, mitomycin C (MMC), mitoxantrone, gemcitabine, etoposide, and especially the platinum-based agents carboplatin and oxaliplatin (Mohamed et al., 2003 Sugarbaker et al., 2005). Agents that do not work well with hyperthermia include irinotecan, paclitaxel, docetaxel, 5-fluorouracil, and floxuridine (Mohamed et al., 2003 Sugarbaker et al., 2005). 

Of course other methods of radiation enhancement may take place with reoxygenation of hypoxic tumor cells that may be increased with the use of chemotherapies like paclitaxel or gemcitabine (41,42), improved drug access to the tumor cells after radiotherapy, or a lowering of the threshold for radiation-induced apoptosis as has been described with the use of gemcitabine (43). 

Gazitt Y, Rothenberg ML, Hilsenbeck SG, Fey V, Thomas C, Montegomrey W. Bcl-2 overexpression is associated with resistance to paclitaxel, but not gemcitabine, in multiple myeloma cells. Int J Oncol 1998 13(4) 839-848. 

Vokes EE, Leopold KA, Herndon JE, et al. CALGB Study 9431 Arandomized phase study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy and concomitant chemoradiotherapy for unresectable stage III non-small cell lung cancer. Lung Cancer 2000 29(Sl) 49(Abstract 158). 

Level Gemcitabine dose Paclitaxel dose Number... 

University of Chicago 73 Paclitaxel/5-FU/Hydrea/Gemcitabine/ hyperfractionated twice-daily XRT CR = 61%, PR = 16%... 

CDDP/docetaxel H CDDP/gemcItabine El Carboplatin/paclitaxel... 

In 10 studies the corresponding clinical study protocol stipulated that cetuximab was to be given in combination with a chemotherapeutic agent (irinotecan, paclitaxel, gemcitabine, cisplatin, carboplatin, or doxorubicin) or in combination with radiation therapy. 

The possible impact of co-administered chemotherapies and radiation therapy on the PK of cetuximab was furthermore assessed using the population PK approach, as described in Section 14.6. The co-administered chemotherapies included cisplatin, carboplatin, paclitaxel, doxorubicin, irinotecan, and gemcitabine. The results of the analysis indicate that neither the co-administered chemotherapies nor radiation therapy had a significant impact on the PK of cetuximab. This finding suggests that the potential for PK-based drug-drug interactions with cetuximab is low. 

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