Cancer Treatment Today » Chemotherapy http://cancertreatmenttoday.org Knowledge is Power Fri, 24 Apr 2026 13:10:44 +0000 en-US hourly 1 Irinotecan for brain metastases of lung and breast cancer http://cancertreatmenttoday.org/irinotecan-for-brain-metastases-of-lung-and-breast-cancer/ http://cancertreatmenttoday.org/irinotecan-for-brain-metastases-of-lung-and-breast-cancer/#comments Fri, 09 Nov 2012 15:38:40 +0000 M Levin, MD http://cancertreatmenttoday.org/?p=9820 Because irinotecan penetrates the brain-blood barrier and has an effect in primary brain cancer, there is some interest in using it for brain metastasis, especially for lung cancer and breast cancer. Most studies of irinotecan had been for brain mets of small(SCLC) and non-small cell lung cancer(NSMCLC) and not breast cancer and have had mixed results. One study enrolled several different cancer types and reported complete responses with irinotecan-based chemotherapy for brain metastases in three patients with SCLC, parotid cancer, and esophageal adenocarcinoma. The combination of cisplatin, ifosfamide and irinotecan in treatment-naive patients with NSCLC led to a response rate in the brain of 50%.  A study of temozolomide (200 mg/m2) on days 1 to 5 and irinotecan (200 mg/m2) on days 1 to 5 every 4 weeks in previously untreated patients with NSCLC brain metastases reported no responses.

There are several ongoing studies for lung cancer. For breast cancer, there is also a study:  Irinotecan and Temozolomide in Treating Patients With Breast Cancer Who Have Received Previous Treatment for Brain Metastases, NCT00617539.

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]]> http://cancertreatmenttoday.org/irinotecan-for-brain-metastases-of-lung-and-breast-cancer/feed/ 0 Taxotere and Cytoxan for metastatic breast cancer http://cancertreatmenttoday.org/taxotere-and-cytoxan-for-metastatic-breast-cancer/ http://cancertreatmenttoday.org/taxotere-and-cytoxan-for-metastatic-breast-cancer/#comments Thu, 18 Oct 2012 02:43:03 +0000 M Levin, MD http://cancertreatmenttoday.org/?p=9559 Preclinical data demonstrate in vitro synergy for combinations of docetaxel (Taxotere) and cyclophosphamide. As single agents, both drugs have proven highly active against breast cancer, and the activity of the combination has been confirmed by several phase II studies. More recently, it has proven adjuvant efficacy on par with anthracycline containing regimen in a trial to directly compare AC to Taxotere/Cytoxan (TC) as adjuvant treatment in breast cancer. This recent trial showed that TC improves disease-free survival compared with AC for the treatment of adjuvant breast cancer. Although cardiac side effects were not presented, the researcher noted that TC does not appear to have the cardiotoxicity issues associated with AC, which is a very important issue for some patients. NCCN considers TC an appropriate regimen for adjuvant treatment for breast cancer. and NCCN 2012 lists this regimen on p. BINV-K.However, NCCN does not list it for metastatic disease.

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]]> http://cancertreatmenttoday.org/taxotere-and-cytoxan-for-metastatic-breast-cancer/feed/ 0 Tykerb and Taxol for metastatic breast cancer http://cancertreatmenttoday.org/tykerb-and-taxol-for-metastatic-breast-cancer/ http://cancertreatmenttoday.org/tykerb-and-taxol-for-metastatic-breast-cancer/#comments Tue, 18 Sep 2012 20:39:08 +0000 M Levin, MD http://cancertreatmenttoday.org/?p=9179 The Taxol and Tykerb combination has recently been shown to improve quality of life in metastatic breast cancer patients versus Taxol alone.  In a phase 3 randomized, multicenter, double-blind, placebo-controlled study, first-line therapy with Tykerb plus Taxol significantly improved clinical outcomes based on a pre-planned. The combination of investigational Tykerb (lapatinib) and Taxol (paclitaxel) as neoadjuant chemotherapy appears effective against inflammatory breast cancer, according to another small study. There are, as of yet in 2012, no published Phase III studies on survival for this regimen.

NCCN does not list the Taxol/Tykerb regimen.

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]]> http://cancertreatmenttoday.org/tykerb-and-taxol-for-metastatic-breast-cancer/feed/ 0 Herceptin and Gemcitabine for Breast Cancer http://cancertreatmenttoday.org/herceptin-and-gemcitabine-for-breast-cancer/ http://cancertreatmenttoday.org/herceptin-and-gemcitabine-for-breast-cancer/#comments Thu, 09 Aug 2012 18:15:57 +0000 M Levin, MD http://cancertreatmenttoday.org/?p=4408 Gemcitabine is a very active drug for breast cancer. Since a study demonstrated that Herceptin(trastuzumab) plus Taxol is associated with a clinical benefit that is superior to that of a Taxol alone,  a number of combinations have been studied, including Herceptin with gemcitabine. A 2006 review in “The Oncologist” cites two trials of gemcitabine/trastuzumab as a second-line therapy; in one trial this combination treatment resulted in a response rate of 36 percent, in the other trial a response rate of 38 percent. A  2009 study  in “Clinical Breast Cancer” concluded that gemcitabine/trastuzumab, while effective, appeared to be less effective than trastuzumab in combination with vinorelbine or the taxanes, paclitaxel and docetaxel, which are other drugs commonly used to treat breast cancer. Another study, published in 2008 in “Cancer Chemotherapy Pharmacology,” evaluated gemcitabine/trastuzumab as a “salvage therapy” and found it “safe and potentially effective.”

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]]> http://cancertreatmenttoday.org/herceptin-and-gemcitabine-for-breast-cancer/feed/ 0 Taxol and Carboplatin for Neoadjuvant Therapy http://cancertreatmenttoday.org/taxol-and-carboplatin-for-neoadjuvant-therapy-2/ http://cancertreatmenttoday.org/taxol-and-carboplatin-for-neoadjuvant-therapy-2/#comments Sun, 05 Aug 2012 14:14:40 +0000 M Levin, MD http://cancertreatmenttoday.org/?p=4248 Docetaxel and carboplatin is a well established chemotherapy regimen for breast cancer. The advantage of this combination is that it does not contain an anthracycline, which can negatively affect heart function. Two independent phase II studies have shown that the combination of carboplatin and docetaxel (Taxotere®; Aventis Pharmaceuticals, Inc.; Bridgewater, NJ) is active in the first-line treatment of metastatic breast cancer.

A recent review concluded: “In several phase II studies, combination carboplatin and paclitaxel (Taxol®; Bristol-Myers Squibb) therapy was active and reasonably well tolerated in the first-line treatment of metastatic breast cancer, producing objective response rates of 53%–62%—substantially higher rates than those seen in other phase II trials of either drug alone. Similar phase II data for carboplatin with docetaxel (Taxotere®; Aventis; Bridgewater, NJ) have been reported in other studies, and recent phase III data suggest that adding carboplatin to a paclitaxel/trastuzumab regimen produces superior efficacy than paclitaxel/trastuzumab alone for patients with HER2+ metastatic disease. Drug scheduling plays an important role in the therapeutic ratio of this combination treatment.”

There is less information on using this regimen for neoadjuvant therapy, treating cancer to shrink it before surgery. There are Phase II studies that suggest the weekly schedule rather once in three weeks schedule for the neoadjuvant settings. NCCN does not specifically list this regimen for neaodjuvant use. However, on p. BINV-12 NCCS says: “in general, dose chemotherapy regimens recommended in the adjuvant setting may be considered in the preoperative setting”. Adjuvant therapy is administered after the primary treatment, breast cancer surgery. Nevertheless, NCCN does not specifically recommend this regimen in the adjuvant setting either.

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