TY - JOUR
T1 - Steroid premedication markedly reduces liver and bone marrow toxicity of trabectedin in advanced sarcoma
AU - Grosso, F.
AU - Dileo, P.
AU - Sanfilippo, R.
AU - Stacchiotti, S.
AU - Bertulli, R.
AU - Piovesan, C.
AU - Jimeno, J.
AU - D'Incalci, M.
AU - Gescher, A.
AU - Casali, P. G.
PY - 2006/7
Y1 - 2006/7
N2 - Trabectedin is a marine-derived cytoxic alkaloid which has shown promising antitumour activity in a variety of human malignancies including sarcoma. Fifty-four patients with advanced sarcoma (age 43 yrs, range 18-70), all pretreated with prior chemotherapy, were enrolled on a named individual basis for treatment with trabectedin. Diagnosis was adult soft tissue sarcoma (STS) in 46 patients, Ewing's family tumour (EFT) in 4, and osteosarcoma (OS) in 4. The initial 23 patients (total number of courses administered: 68) did not receive premedication prior to trabectedin, while the other 31 patients (total number of courses administered: 134) received premedication with dexamethasone 4 mg po bid 24 hours before therapy. Incidence of toxicity (grade 3-4), expressed as percentage of courses, was as follows: in patients without dexamethasone, elevation of transaminases 34%, neutropenia 24% and thrombocytopenia 25%; in patients with prior dexamethasone, elevation of transaminases 2%, neutropenia 2% and no thrombocytopenia. The median received dose intensity of trabectedin was superimposable in the two groups (404 μg and 400 μg per week, respectively), as well as progression-free survival (19% at 6 months). Among STS patients, 9% had objective responses. In this unselected patient series, premedication with dexamethasone strongly reduced drug-induced hepatotoxicity and myelosuppression.
AB - Trabectedin is a marine-derived cytoxic alkaloid which has shown promising antitumour activity in a variety of human malignancies including sarcoma. Fifty-four patients with advanced sarcoma (age 43 yrs, range 18-70), all pretreated with prior chemotherapy, were enrolled on a named individual basis for treatment with trabectedin. Diagnosis was adult soft tissue sarcoma (STS) in 46 patients, Ewing's family tumour (EFT) in 4, and osteosarcoma (OS) in 4. The initial 23 patients (total number of courses administered: 68) did not receive premedication prior to trabectedin, while the other 31 patients (total number of courses administered: 134) received premedication with dexamethasone 4 mg po bid 24 hours before therapy. Incidence of toxicity (grade 3-4), expressed as percentage of courses, was as follows: in patients without dexamethasone, elevation of transaminases 34%, neutropenia 24% and thrombocytopenia 25%; in patients with prior dexamethasone, elevation of transaminases 2%, neutropenia 2% and no thrombocytopenia. The median received dose intensity of trabectedin was superimposable in the two groups (404 μg and 400 μg per week, respectively), as well as progression-free survival (19% at 6 months). Among STS patients, 9% had objective responses. In this unselected patient series, premedication with dexamethasone strongly reduced drug-induced hepatotoxicity and myelosuppression.
KW - Advanced sarcoma
KW - Steroid premedication
KW - Toxicity
KW - Trabectedin
UR - http://www.scopus.com/inward/record.url?scp=33745161449&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745161449&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2006.02.010
DO - 10.1016/j.ejca.2006.02.010
M3 - Article
C2 - 16737808
AN - SCOPUS:33745161449
VL - 42
SP - 1484
EP - 1490
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 10
ER -