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ASCO 2003 - Congrès de la société américane d'oncologie médicale

Résumés des communications algériennes présentées lors du dernier congrès
de la société américane d'oncologie médicale (ASCO 2003)

Gemcitabine and cisplatine (GC) doublet in the treatment of locally advanced or metastatic non small cell lung cancer (NSCLC): Experience of the Department of Medical Oncology in Algiers.
2003 - Abstract n° 2733
M. Gamaz, K. Bouzid; Medical Oncology, Algiers, Algeria

The aim of the study were to determine the efficacy and toxicity of the GC combination in patients (pts) with NSCLC.
Patients and methods : Pts with locally advanced or metastatic NSCLC received C 70 mg/m2 on day 1 and G 1250 mg/m2 on days 1 and 8 every 3 weeks.
Results : from January 1998 to September 2002, 167 pts (151 male, 16 female) were treated in our single institution. The median age of the pts was 57,3 years (range: 27-76). Histological subtypes were adenocarcinoma in 68 pts, squamous celle carcinoma in 88 pts, and large cell carcinoma in 11 pts. Stage IIIA, IIIB, and IV disease was reported in 21, 60 and 86 pts, respectively. A total of 638 cycles was admistered, with a median of 6 cycles (range, 3-9) per pt. Of the 146 evaluable pts, 2 (1,4%) had complete response and 41(28,1%) had partial response, for an overall response rate of 29,5%. Progressive disease was observed in 74 (50,7%) pts and stable disease in 29 (20%) pts. The median time to progression was 6 months (CI 2-10 months) and the median survival time was 7,8 months (CI 4,7-10,9 months). Grade 3-4 (CTC-NCI) hematological toxicities were neutropenia in 1,8% thrombocytopenia in 1,2% and anemia in 9,4% of pts. No febrile neutropenia, no grade 3-4 non-hematological toxicities and no death occured during this trial.
Conclusion : The results of our single institution study confirm that GC is an effective and well-tolerated regimen. Based on our experience, we consider the GC doublet a treatment options for pts with NSCLC.

A phase II study of gemcitabine (G) and cisplatin (C) combination in the treatment of recurrent cervical squamous cell carcinoma (RCSCC)
2003 - Abstract n° 1900
K. Bouzid, H. Mahfouf; Department of Medical Oncology, E.H.S Pierre & Marie Curie Center, Algiers, Algeria

Introduction : Gemcitabine, a nucleoside analog, possesses activity in the treatment of RCSCC (Proc ASCO 1996, abs #819; Proc ASCO 2000, abs #1549; Proc ASCO 2001, abs #824).
Objectives : Evaluate efficacy and toxicity of G plus C in pretreated pts with RCSCC.
Methods : Since December 1998, 57 pts received 6 courses of G 1,250 mg/m2 d1 & 8 plus C 70 mg/m2 d1, q3wks.
Eligibility criteria : histologically verified cervical squamous cell carcinoma, PS£2, adequate bone marrow reserve, good liver/kidney function, life expectancy exceeding 12 wks, and written informed consent.
Results : Fifty-seven pts enrolled and 46 pts were evaluable for response.
Pt characteristics : median age 53 yrs (range 31-69), FIGO stage II bulky disease (21 pts), stage III (25), stage IVA (11). Six pts relapsed after surgery, 38 pts after radiation therapy (RT), and 13 pts after surgery plus RT.
Sites of recurrence : local (44 pts), bone (5), lymph nodes (4), lung (3), liver (1). A total of 254 cycles was administered. Overall response rate was 50%, with a complete response in 7 pts (15%), a partial response in 16 (35%), and stable disease in 3 (7%). Twenty pts (43%) progressed during the study. Three pts with complete response relapsed after 4, 11, and 12 mos, respectively. One-year and two-year survival were respectively 44% and 26%.
NCI-CTC grade 3 hematologic toxicity consisted of : anemia (3%), thrombocytopenia (5%), neutropenia (1%); no febrile neutropenia was reported.
Grade 3 nonhematologic toxicity : fatigue (20%).
Conclusion : The GC combination is a promising regimen in the treatment of RCSCC.

Phase II trial with the gemcitabine and cisplatin combination in the treatment of locally advanced and metastatic gall bladder carcinoma
2003 - Abstract n° 1302
L. Abid, M. Oukkal, S. Berkane, H. Mahfouf, J. Asselah, K. Bouzid; Department of Surgery, Noureddinne El-Atassi Hospital, Algiers, Algeria; Department of Medical Oncology, Pierre & Marie Curie Center, Algiers, Algeria

Introduction : Gall bladder carcinoma is the leading cause of death among digestive tract cancers in Algerian women, with an annual incidence of 8 per 100,000. It has both a poor prognosis and low response to classic chemotherapeutic regimens. Biliary tract cancer has the same embryologic origin as exocrine pancreatic carcinoma. Because of the documented activity of gemcitabine (G) and cisplatin (C) in the treatment of pancreatic cancer, this combination may possess activity in gall bladder carcinoma.
Objectives : To determine the efficacy and safety of G plus C in gall bladder carcinoma.
Methods : Between March 2000 to Sept 2002, 36 pts received G 1,250 mg/m2 on d1,8 plus C 70 mg/m2 on d1, every 3 wks.
Inclusion criteria : no prior chemotherapy, histologically proven carcinoma of the gall bladder, measurable disease, PS £ 2, adequate renal/liver function, good bone marrow reserve, life expectancy ³ 12 wks, written informed consent. Clinical benefit response (CBR) was defined by analgesic consumption, PS, and weight change. NCI-CTC grade 3/4 hematologic toxicity was evaluated after 180 cycles.
Results : 36 pts enrolled. 23 pts were evaluable for response; all pts were evaluable for toxicity and CBR. Pt characteristics: M/F 3/33; median age 58 yrs (range 36-70). A total of 120 cycles was administered with a median of 3.3 (range 1-8). Overall response rate was 39%, with a CR in 4 pts (17%), PR in 5 (22%), and SD in 4 (17%). A CBR was achieved in 19 pts (53%). Median survival was 5.7 months. Grade 3/4 hematologic toxicity consisted of anemia (3% of cycles), neutropenia (4%), thrombopenia (2%); no febrile neutropenia was reported. Grade 3/4 nonhematologic toxicity: nephrotoxicity (2%).
Conclusions : Gemcitabine plus cisplatin is an active and well-tolerated combination in the treatment of gall bladder carcinoma. Moreover, the CBR data are particularly interesting in relating to the improvement in the patients' quality of life



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