Chemotherapy for advanced thymoma preliminary: Results of an intergroup study

Patrick J. Loehrer, Carlos A. Perez, Lawrence M. Roth, F. Anthony Greco, Robert B Livingston, Lawrence H. Einhorn

Research output: Contribution to journalArticle

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Abstract

Objective: To determine the efficacy of combination therapy with cisplatin, doxorubicin, and cyclophosphamide alone or with radiotherapy for patients with extensive and those with limited unresectable thymoma. Design: Nonrandomized, prospective phase I-II trial. Setting: A Cooperative Oncology Group trial involving tertiary medical centers. Patients: Twenty of twenty-two patients with measurable, extensive or limited, unresectable thymoma were evaluable for response. Intervention: Patients were given cisplatin, 50 mg/m2 body surface area, doxorubicin, 50 mg/m2, and cyclophosphamide, 500 mg/m2, on day 1, with cycles repeated every 21 days until progression or until the maximally tolerated total doxorubicin dosage (for example, 450 mg/m2) was reached. Intravenous hydration with normal saline was administered during treatment courses. For responding patients with limited disease, 4500 cGy was administered to primary tumors after the second cycle of chemotherapy and before the initiation of the third cycle. Measurements and Main Results: Three complete and eleven partial remissions were seen in 20 evaluable patients, for a total response rate of 70% (95% CI, 46% to 88%). The median duration of remission was 13 months with three patients remaining continuously disease free for over 2 years. The median survival time of all eligible patients was 59 months (CI, 22 months to infinity). Four patients developed infections, including listerial and aseptic meningitides, mucocutaneous candidiasis, and cryptococcal pneumonia, that were indicative of a defect in cell-mediated immunity. Conclusions: Combination therapy with cisplatin, doxorubicin, and cyclophosphamide frequently produces objective remissions in patients with advanced thymoma. Further experience with this treatment regimen is warranted to clarify potential prognostic factors in patients with unresectable thymoma.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalAnnals of Internal Medicine
Volume113
Issue number7
StatePublished - Oct 1 1990
Externally publishedYes

Fingerprint

Thymoma
Drug Therapy
Doxorubicin
Cyclophosphamide
Cisplatin
Aseptic Meningitis
Candidiasis
Body Surface Area
Therapeutics
Cellular Immunity
Pneumonia
Radiotherapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Loehrer, P. J., Perez, C. A., Roth, L. M., Greco, F. A., Livingston, R. B., & Einhorn, L. H. (1990). Chemotherapy for advanced thymoma preliminary: Results of an intergroup study. Annals of Internal Medicine, 113(7), 520-524.

Chemotherapy for advanced thymoma preliminary : Results of an intergroup study. / Loehrer, Patrick J.; Perez, Carlos A.; Roth, Lawrence M.; Greco, F. Anthony; Livingston, Robert B; Einhorn, Lawrence H.

In: Annals of Internal Medicine, Vol. 113, No. 7, 01.10.1990, p. 520-524.

Research output: Contribution to journalArticle

Loehrer, PJ, Perez, CA, Roth, LM, Greco, FA, Livingston, RB & Einhorn, LH 1990, 'Chemotherapy for advanced thymoma preliminary: Results of an intergroup study', Annals of Internal Medicine, vol. 113, no. 7, pp. 520-524.
Loehrer PJ, Perez CA, Roth LM, Greco FA, Livingston RB, Einhorn LH. Chemotherapy for advanced thymoma preliminary: Results of an intergroup study. Annals of Internal Medicine. 1990 Oct 1;113(7):520-524.
Loehrer, Patrick J. ; Perez, Carlos A. ; Roth, Lawrence M. ; Greco, F. Anthony ; Livingston, Robert B ; Einhorn, Lawrence H. / Chemotherapy for advanced thymoma preliminary : Results of an intergroup study. In: Annals of Internal Medicine. 1990 ; Vol. 113, No. 7. pp. 520-524.
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abstract = "Objective: To determine the efficacy of combination therapy with cisplatin, doxorubicin, and cyclophosphamide alone or with radiotherapy for patients with extensive and those with limited unresectable thymoma. Design: Nonrandomized, prospective phase I-II trial. Setting: A Cooperative Oncology Group trial involving tertiary medical centers. Patients: Twenty of twenty-two patients with measurable, extensive or limited, unresectable thymoma were evaluable for response. Intervention: Patients were given cisplatin, 50 mg/m2 body surface area, doxorubicin, 50 mg/m2, and cyclophosphamide, 500 mg/m2, on day 1, with cycles repeated every 21 days until progression or until the maximally tolerated total doxorubicin dosage (for example, 450 mg/m2) was reached. Intravenous hydration with normal saline was administered during treatment courses. For responding patients with limited disease, 4500 cGy was administered to primary tumors after the second cycle of chemotherapy and before the initiation of the third cycle. Measurements and Main Results: Three complete and eleven partial remissions were seen in 20 evaluable patients, for a total response rate of 70{\%} (95{\%} CI, 46{\%} to 88{\%}). The median duration of remission was 13 months with three patients remaining continuously disease free for over 2 years. The median survival time of all eligible patients was 59 months (CI, 22 months to infinity). Four patients developed infections, including listerial and aseptic meningitides, mucocutaneous candidiasis, and cryptococcal pneumonia, that were indicative of a defect in cell-mediated immunity. Conclusions: Combination therapy with cisplatin, doxorubicin, and cyclophosphamide frequently produces objective remissions in patients with advanced thymoma. Further experience with this treatment regimen is warranted to clarify potential prognostic factors in patients with unresectable thymoma.",
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