O-MAX Chemotherapy: High Activity in Metastatic Esophagogastric Adenocarcinoma and Possible Relation to Subclinical Hemolysis

被引：2

作者：

Ahlgren, James ^{[1
]}

Patel, Nihar ^{[1
]}

Simmens, Samuel ^{[2
]}

Akin, Esma ^{[3
]}

Bishop, Catherine ^{[4
]}

Kirkel, Dean ^{[6
]}

Siegel, Paula ^{[7
]}

Schuck, Suzanne ^{[5
]}

Guebre-Xabiher, Hiwot ^{[1
]}

Siegel, Robert ^{[1
]}

机构：

[1] George Washington Univ, Med Ctr, Div Hematol & Oncol, Washington, DC 20037 USA

[2] George Washington Univ, Dept Epidemiol & Biostat, Washington, DC 20037 USA

[3] George Washington Univ Hosp, Dept Radiol, Washington, DC USA

[4] Sibley Mem Hosp, Johns Hopkins Kimmel Canc Ctr, Washington, DC USA

[5] George Washington Univ, Clin Trials Unit, Med Fac Associates, Washington, DC 20037 USA

[6] NW Georgia Oncol Ctr, Atlanta, GA USA

[7] Virginia Canc Specialists, Fairfax, VA USA

来源：

ONCOLOGY | 2014年 / 87卷 / 06期

关键词：

Gastric cancer; Esophageal adenocarcinoma; Chemotherapy; Complete remission; Subclinical hemolysis; ADVANCED GASTRIC-CANCER; CONTINUOUS-INFUSION; 5-FLUOROURACIL; FAM COMBINATION CHEMOTHERAPY; PHASE-II; CISPLATIN; FLUOROURACIL; DOXORUBICIN; MITOMYCIN; TRIAL; EPIRUBICIN;

D O I：

10.1159/000366425

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Our objectives were to confirm the activity of O-MAX chemotherapy in adenocarcinoma of the stomach and esophagus, particularly the high rate of complete remission (CR) and the relation of subclinical hemolysis to CR. Patients and Methods: Twenty-five patients with metastatic esophagogastric adenocarcinoma were treated with O-MAX. Two developed cancer-related hemolytic-uremic syndrome (C-HUS); both achieved CR. Subsequent patients were monitored for serum haptoglobin for subclinical hemolysis. Results: Median survival was 16.5 months. The objective response rate was 90%, with 38% CR. Three patients achieving CR relapsed in the central nervous system and died (2 without systemic disease). Four patients have remained alive, off therapy, the longest for 20 years. Two patients developed clinical C-HUS and 5 of 8 monitored patients developed subclinical hemolysis based on abnormal serum haptoglobin. Four of the patients with subclinical hemolysis achieved CR. Of the 7 patients developing clinical C-HUS or subclinical hemolysis, 6 (86%) achieved CR. Conclusions: O-MAX appears highly active in esophagogastric adenocarcinoma. A few long-term survivors of metastatic disease are being seen. CR and long-term survival appear to correlate with the development of hemolysis. Although highly promising, these results should be considered only as hypothesis-generating and require confirmation in a prospective trial. (C) 2014 S. Karger AG, Basel

引用

页码：371 / 380

页数：10