Session - Respiratory & Critical Care Medicine: no. G-RC-10published_or_final_versio

Ho, JCM

Ip, MSM

Lam, WK

Ooi, CGC

Tsang, KWT

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Title Multicentre phase II trial of taxotere and cisplatin in advancednon-small cell lung cancerAuthor(s) Ho, JCM; Lam, WK; Ooi, CGC; Ip, MSM; Tsang, KWTCitation The 5th Medical Research Conference, Hong Kong, China,January 2000, v. 22 n. Supp 2, p. 21Issued Date 2000URL http://hdl.handle.net/10722/45736Rights Creative Commons: Attribution 3.0 Hong Kong LicenseG-RC-10MULTICENTRE PHASE II TRIAL OF TAXOTERE AND CISPLATIN IN ADVANCED NON-SMALLCELL LUNG CANCERJames CM Ho. WK Lam, *Clara Ooi, Mary Ip, Kenneth Tsang University Departments of Medicine and*Diagnostic Radiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong SARNon-small cell lung cancer is the commonest cause of cancer death in Hong Kong and frequently presentsitself at advanced stages. Combination chemotherapy has been used in advanced stages with unsatisfactoryresponse. We have performed a phase II study on the response rate and safety profile of Taxotere and cisplatingiven in combination in patients with metastatic or locally advanced non-small cell lung cancer (NSCLC).Chemotherapy naive patients with histologically or cytologically proven stage III or IV unresectable NSCLCand good performance state were recruited consecutively. Exclusion criteria included brain or leptomeningealinvolvement, major organ failure, previous malignancies, active uncontrolled infection, or definitecontraindications for the use of corticosteroids. Taxotere 75mg/m2 as 1 hour intravenous infusion and cisplatin75mg/m2 as 30 minutes intravenous infusion were given in 3-weekly intervals for 6 cycles. Interim resultswere obtained from 20 patients (10F) with age 55.8+7.34 years. There were 14 adenocarcinomas, 3 squamouscell carcinoma and 3 undifferentiated NSCLC with 2 in TNM stage III A, 10 in stage IIIB and 8 in stage IV.The partial response rate after 3 courses of chemotherapy was 42% and 47% had stable disease. After completionof 6 courses of chemotherapy, the overall response rates were 53%, 26% had stable disease, and 21 % progressivedisease. Grade 3 or 4 neutropenia occurred in 55% of chemotherapy cycles in which 4 out of 20 patientsrequired dose reduction and 3 of them required granulocyte-colony stimulating factor support. Neutropenicfever occurred in 17%. Grade 3 thrombocytopenia occurred in 3%. Significant toxicities (grade 3 or 4)included nausea (1%), vomiting (10%), diarrhoea (2%), infection (3%), asthenia (2%) and allergy (1%). Therehad been no treatment-related deaths. The combination of Taxotere and cisplatin appears to be a fairly welltolerated and highly effective regime in the treatment of advanced NSCLC. Further studies are warranted toevaluate the impact of this combination on the median term response and survival of these unfortunate patients.G-RC-11SERUM LEPTIN AND VASCULAR RISK FACTORS IN OBSTRUCTIVE SLEEP APNOEAMary SM Ip, Karen SL Lam, Chung-man Ho. Kenneth WT Tsang, Wah-kit Lam. University Department ofMedicine, Queen Mary Hospital, Hong KongStudy objectives: To define the metabolic profile relevant to vascular risks in obstructive sleep apnoea (OSA)and the role of leptin resistance in this risk profileDesign: Case control studySetting: Sleep Laboratory, Queen Mary Hospital, University of Hong KongMethods: Thirty OSA subjects were compared with 30 non-OSA subjects, matched for body mass index(BMI), age, sex and menopausal status, in the following parameters : girth of neck, waist and hip, skinfoldthickness, fasting serum levels of lipids, glucose, insulin and leptin.Results: Compared to control subjects without OSA, despite a similar BMI, the OSA group had a significantlymore adverse vascular risk factor profile including dyslipidemia, higher diastolic blood pressure, insulinresistance, and greater adiposity reflected by skinfold thickness. OSA subjects also had higher circulatingleptin levels (9.2±4.2 vs 6.5± 3.8 ng/ml, mean ± SD, p=0.001). Serum leptin levels correlated positively withBMI, skinfold thickness, serum cholesterol, LDL-cholesterol, insulin, insulin:glucose ratio, apnoea-hypopneaindex and oxygen desaturation time, and multiple stepwise regression analysis identified skinfold thickness,waist : hip ratio, serum LDL-cholesterol, and diastolic blood pressure as independent correlates, while onlyserum insulin and diastolic blood pressure were independent correlates in OSA subjects. After treatment withnCPAP for 6 months, there was a significant decrease in circulating leptin (p =0.01) and triglyceride levels(p=0.02) without change in anthropometric and other metabolic characteristics.Conclusion: Despite controlling for BMI, OSA subjects showed a distinct profile with clustering of vascularrisk factors. Hyperleptinaemia was present in OSA subject but it can be normalised by treatment with nCPAP,suggesting that increased leptin resistance was not the cause of OSA or its associated vascular risks.- 21 -

Multicentre phase II trial of taxotere and cisplatin in advanced non-small cell lung cancer

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Multicentre phase II trial of taxotere and cisplatin in advanced non-small cell lung cancer

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