Campostar & Taxol

[SharKats]

If this has been discussed before, please, I do apologize but I just wanted to hear how other people reacted to this combination of chemo? It really scares me.

[mhutch1366]

Sharlene,

I didn't have this combination.

I do know chemo affects people differently.

I know it goes easier if you premed for nauseaa, including oral zofran and atavan. I would also get 1-2 L saline with the premeds before the chemo.

If you are otherwise healthy, that is good nutrtional status and strong, that is able to move about well, the toll taken is much less.

Other than that, dear, it is fear of the unknown. It isn't anywhere near as awful as you're imagining it to be.

Take heart, do something else between now and then, and if you get too scared, say your prayers. It helps.

XOXOXOX

Prayers always,

MaryAnn

[SharKats]

Well, I did a Google search and found some info on Camptosar - it is used for cancers of colon and rectum that have metastised. (spelling?) So why am I getting it?

I went to the lung cancer section of the NCI web site - no mention of Camptosar/Taxol being used to treat recurrent small cell lung cancer. I called, the cancer specialist rep was unable to locate any mention of Camptosar (irinotecan) used in conjunction with Taxol. That made me feel somewhat less incompetent - even her boss couldn't find anything.

I was in such a befuddled state Thursday when I got the news I forgot to ask any info about these 2 drugs - how much success they'd had - how long had this particular combo been used in smcl, etc. Hopefully I can find out some info Monday before this treatment starts Tuesday.

[kimblanchard]

I've never seen that particular combination used although they are both active drugs for treatment of small cell but have not seen them used together. Here's what I could find:

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=10981293

http://www.ncbi.nlm.nih.gov/entrez/quer ... s=12375799

Here is the relevant portion of the latter review, you have to give this website a DEA number to register so unfortunately don't think you'll be able to pull it up on your own.

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Combinations of Paclitaxel and Irinotecan

Several phase I studies have also been performed evaluating the combination of paclitaxel and irinotecan (see Table 2).[30-34] Most studies have achieved similar dose intensity and use some variant of a weekly dosing schedule. The dose-limiting toxicity is commonly related to severe neutropenia. Interestingly, an early report by DeMario et al of paclitaxel dosed at 80 mg/m² followed by irinotecan at 30 mg/m² given weekly for 3 weeks on an every-4-week cycle was complicated by prolonged grade 4 lymphopenia in 4 of 4 patients, lasting a mean duration of 12.8 days.[30] Two patients (50%) developed fungal sepsis in the first cycle and their protocol required paclitaxel dose reduction. Two Japanese pharmacokinetic analyses of phase I trials show that paclitaxel increases the AUC (area under the concentration-time curve) of irinotecan and its metabolites (such as

SN-38 ).[31,32]

Rushing et al performed a phase I/II trial evaluating weekly paclitaxel/irinotecan specifically in treating small-cell lung cancer.[33] They were able to escalate doses to a recommended dose of paclitaxel at 50 mg/m² and irinotecan at 60 mg/m² weekly for 3 weeks on an every 4-week cycle. However, out of 19 enrolled patients, grade 4 toxicities included sudden demise due to acute pulmonary embolus, septic shock in the setting of neutropenia, thrombocytopenia, and dehydration without diarrhea or vomiting. Out of seven patients evaluable for response, three (43%) had complete response and five had at least partial response (71%). A phase II study was initiated and results are pending; however, it was designed to administer paclitaxel/irinotecan immediately after induction therapy with etoposide/platinum, so it will be difficult to ascertain the contribution of the paclitaxel/irinotecan portion to the observed outcomes.

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Irinotecan in particular can be tough in terms of causing diarrhea and low blood counts. Make sure you let your doctor know right away about diarrhea or fevers. Sounds like it is a pretty active combination.

Hope it kills off the bad guys!

[SharKats]

Docjoe,

Thank you for providing this info, that was very kind of you. I still have chemo brain left over from Jan - end of April so I didn't really comprehend all of it.

So........... I just have one more question, would you let them administer this combo you you if you have recurrent sclc??

[MayFrog]

Hi Shar,

Can understand how scary this is for you. Can't offer much help, but i do know that irenotecan is widely used for SCLC with excellent results.....have no clue on the combo with Taxol, though.....

Wishing you the best,

Mary

[Andrewsmom]

I believe this combination of chemotherapy saved my life. In fact, I chose my oncologist specifically because of his success rate with smlc patients. His method of treatment was to automatically gives otherwise healthy limisted stage sclc patients this combination after the standard cisplatin/VP-16 with simultaneous lung radiation and pci. It may seem to be a bit excessive but by the time I was done I don't think any of those cancer cells could possibly still be alive. His position was to hit the cancer with everything in the arsonal.

Now, I will say that the Comptasar/Taxol treatments just about killed me. For the first time during my 10 months of treatment I got really sick and had to have a home nurse come and hook me up to IVs of saline to rehydrate me. Then, my husband had to learn to do it which was a real adventure in pain management.

But, that was 2 years ago (3 years since diagnosis) and I feel better than I have in years.

Hope this helps.

Rebecca

[Cindy RN]

CAMPTOSAR-it has been used for extensive sclc for a about 4-5 yrs now. I know much of what you read tells about the colon use tho. It was used in a study in Japan and the success rate was so GOOD they stopped testing and used it. Then here in the US they 'fast tracked' it for approval on sclc.

My first go around with the ca was with cisplatin and camptosar for 9 mos. The second time it relapsed I had carboplatin and vp-16 for 6 mos. I am still here -now 3 yrs 9 mos since diagnosis.

Good luck!! Cindy

[kimblanchard]

Hi Shar, this is a little late but I think the treatment that is being proposed is reasonable. I've not used it because I haven't seen enough published on it yet but there are some trials with it and it certainly seems to be active. They are both very good sclc drugs.

[SharKats]

Thanks very much to everyone that replied. And Doc Joe, I am glad you feel these are both good cancer fighting drugs and that using them in tandum is a good idea. I posted this question because I just don't want to die from taking these two chemos and was interested in knowing if anyone else had rec'd this particular "cocktail".

Thanks again!