Respons Dan Toleransi Pasien Adenokarsinoma Paru Stage III Dan IV Untuk Pemberian Kemoterapi Dengan Rejimen Paclitaxel (Paxus®) Plus Carboplatin

· Thoracic Oncology

Syahruddin E, Hudoyo A, Jusuf A. J Respir Indones. 2010;30(2):105-111.

Purpose: Combined new agents (paclitixel, gemcitabine and docetaxel) with platinum based were used as standard chemotherapy for non-small cell lung cancer. Meta analysis study that four regimen have similar efficacy, such as paclitaxel and cisplatin. Paxus® is a new paclitaxel derived from Taxus chinesis plant by cell culture, which is a semi synthetic process. Clinical trial in NSCLC patients in Korea showed that Ganexol®/Paxus® had no less response than the former paclitaxel, with no considerable toxicity other than previously reported. The purpose of our clinical trial in Persahabatan Hospital Jakarta is to evaluate the efficacy and safety of a combination regimen of paclitaxel (Paxus®) and carboplatin in patients with non-small cell lung cancer.
Subjects and methods: Chemotherapy naive patients with confirmed non-small cell lung cancer, stage III-IV with good performance status and normal laboratory parameters were enrolled. Paclitaxel (Paxus®) were administrated at 175 mg/m2 as 3-hours and carboplatin at AUC-5 as an intravenous infusion on day 1 every 3 weeks at least 2 cycles must be given before evaluation of response.
Results: Thirty-nine patients were enrolled a treated between January–December 2005. Thirty of them were included for evaluation and 9 patients were unevaluable. The mean number of cycle of therapy was 5.1 cycles in range 2 – 6 cycles. Among 30 evaluable patients, 1 (3,4%) patient showed complete response, 13 (43,3%) patients had partial response. Overall response rate was 46.7% and 13 patients (43.3%) showed stable disease. The frequent toxicities occurred during treatment were grade 1-2 anemia in 23 (76.6%) patients and non-hematological toxicities were mild except neuropathy grade 3 in 3 (10.7%) patients. Median time to progression was 4,2 months, median survival time was 10 months with one year survival rate 30 %.
Conclusion: In this clinical observation, combination of paclitaxel (Paxus®) and carboplatin showed no differences in efficacy and safety compare to other chemotherapeutic agents such as paclitaxel, docetaxel, gemcitabine, vinorelbine combination with platinum base in patients advanced NSCLC.

Keywords: adenocarcinoma, advanced stage, chemotherapy, paclitaxel, paxus, non small cell lung carcinoma, kanker paru karsinoma bukan sel kecil, kpkbsk, nsclc, carboplatin, kemoterapi, platinum based

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