levoleucovorin and Respiratory-Distress-Syndrome

Phase II trials of combination chemotherapies have shown encouraging palliative benefit, objective response rates, and survival outcomes. Until ongoing phase III trials confirm these benefits, the current standard treatment for metastatic pancreatic adenocarcinoma remains single agent gemcitabine. The fixed rate infusion schedule of 10 mg/m2/min is gaining wide acceptance and is a promising investigational priority. A very reasonable alternative to single agent gemcitabine, and our bias, is enrollment into clinical trials evaluating novel gemcitabine-based combinations. Further investigation is needed to determine optimal incorporation of so-called targeted therapy with combination chemotherapy.

Topics: Adenocarcinoma; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Diseases; Camptothecin; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Deoxycytidine; Docetaxel; Enzyme Inhibitors; Epirubicin; Fluorouracil; Gemcitabine; Hemolytic-Uremic Syndrome; Humans; Interferon alpha-2; Interferon-alpha; Irinotecan; Leucovorin; Multicenter Studies as Topic; Organoplatinum Compounds; Paclitaxel; Palliative Care; Pancreatic Neoplasms; Recombinant Proteins; Respiratory Distress Syndrome; Taxoids; Treatment Outcome

Oxaliplatin has been approved for adjuvant treatment of colorectal cancer. Toxicity induced by oxaliplatin is moderate and manageable, but some isolated cases of severe pulmonary toxicity associated to oxaliplatin have been reported. Two fatal cases of interstitial pneumonitis rapidly evolving to pulmonary fibrosis are reported here.

Topics: Adenocarcinoma; Aged; Antineoplastic Agents, Alkylating; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Fatal Outcome; Female; Fluorouracil; Granulomatosis with Polyangiitis; Humans; Leucovorin; Lung Diseases, Interstitial; Lung Neoplasms; Male; Organoplatinum Compounds; Oxaliplatin; Pneumonectomy; Postoperative Complications; Pulmonary Alveoli; Pulmonary Fibrosis; Respiratory Distress Syndrome; Sigmoid Neoplasms; Tomography, X-Ray Computed

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Cyclophosphamide; Dexamethasone; Doxorubicin; Drug Interactions; Drug Therapy, Combination; Female; Humans; Leucovorin; Lung Diseases; Lymphoma; Male; Methotrexate; Pulmonary Fibrosis; Respiratory Distress Syndrome; Testicular Neoplasms; Vinblastine; Vincristine