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Biomedical subjects

George A Omura

Publications and source records attributed to George A Omura.

9 recordsLinked to original sources
PubMed2003

Phase III trial of paclitaxel at two dose levels, the higher dose accompanied by filgrastim at two dose levels in platinum-pretreated epithelial ovarian cancer: an intergroup study.

PURPOSE: To determine if increasing the dose of paclitaxel increases the probability of clinical response, progression-free survival, or overall survival in women who have persistent or recurrent ovarian cancer, and whether doubling the dose of prophylactic filgrastim accompanying the higher paclitaxel dose decreases the frequency of neutropenic fever. PATIENTS AND METHODS: Consenting patients with persistent, recurrent, or progressing ovarian cancer, despite first-line platinum therapy (but no prior taxane), were randomly assigned to paclitaxel 135 mg/m2, 175 mg/m2, or 250 mg/m2 over 24 hours every 3 weeks. Patients receiving paclitaxel 250 mg/m2 were also randomly assigned to 5 or 10 microg/kg of filgrastim per day subcutaneously. RESULTS: Accession to the paclitaxel 135-mg/m2 arm was closed early. Among the 271 patients on the other regimens with measurable disease, partial and complete response on paclitaxel 250 mg/m2 (36%) was significantly higher than on 175 mg/m2 (27%, P =.027). This difference was more evident among patients who never responded to prior platinum. However, progression-free and overall survival results were similar. The median durations of overall survival were 13.1 and 12.3 months for paclitaxel 175 mg/m2 and 250 mg/m2, respectively. Thrombocytopenia, neuropathy, and myalgia were greater with paclitaxel 250 mg/m2 (P <.05). The incidence of neutropenic fever after the first cycle of paclitaxel 250 mg/m2 was 19% and 18% on the 5-microg/kg and 10-microg/kg filgrastim dose, respectively (22% for paclitaxel 175 mg/m2 without filgrastim). CONCLUSION: Paclitaxel exhibits a dose effect with regard to response rate, but there is more toxicity and no survival benefit to justify paclitaxel 250 mg/m2 plus filgrastim. Doubling the filgrastim dose from 5 to 10 microg/kg did not reduce the probability of neutropenic fever after high-dose paclitaxel.

Adult↗
PubMed2002

Advances in the treatment of gynecologic malignancies. Part 1: Cancers of the cervix and vulva.

Two recent multicenter randomized trials have greatly advanced our understanding of the role of postoperative radiation therapy in operable cervical cancer. In locally advanced cervical cancer, such studies have shown a significant improvement in survival with the use of concurrent cisplatin-based chemoradiotherapy and have redefined standard therapy for women with this presentation. In vulvar cancer, adjuvant chemoradiotherapy is emerging as an effective therapeutic approach, permitting less morbid surgery. Although the results of treatment with concurrent chemoradiotherapy are encouraging in both cervical and vulvar cancer, efforts to minimize the associated toxicity are needed.

Antineoplastic Agents↗
PubMed2002

Advances in the treatment of gynecologic malignancies. Part 2: Cancers of the uterine corpus and ovary.

Over the past few decades, we have gained a better understanding of the risk factors associated with the recurrence of endometrial cancer. Adjuvant postoperative radiotherapy in an intermediate-risk group of endometrial cancer patients resulted in improvement in local control, but survival was not improved significantly. Postoperative management of uterine sarcomas remains investigational. The management of ovarian cancer has notably advanced during the 1990s. Platinum- and paclitaxel-based combination chemotherapy set a new standard of care for patients with advanced ovarian cancer. During the late 1990s, a trend emerged favoring the use of carboplatin over cisplatin for first-line management of advanced ovarian cancer because of its more favorable safety profile. Adjuvant therapy for early-stage high-risk ovarian cancer continues to be actively investigated.

Antineoplastic Combined Chemotherapy Protocols↗