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Amifostine before chemotherapy: Improved tolerance profile of the subcutaneous over the intravenous route
The i.v. administration of the cytoprotective agent amifostine is associated with reversible clinical hypotension, protracted emesis, and malaise in a various percentage of patients. We evaluated, prospectively, whether the s.c. route is a better tolerated alternative to the i.v. route in patients r...
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Published in: | Clinical cancer research 2003-08, Vol.9 (9), p.3288-3293 |
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creator | KOUKOURAKIS, Michael I SIMOPOULOS, Costantinos MINOPOULOS, George PATLAKAS, George POLYCHRONIDIS, Alexandros LIMBERIS, Vassilis ROMANIDES, Kostantinos PITIACOUDIS, Michael MANOLAS, Costantinos |
description | The i.v. administration of the cytoprotective agent amifostine is associated with reversible clinical hypotension, protracted emesis, and malaise in a various percentage of patients. We evaluated, prospectively, whether the s.c. route is a better tolerated alternative to the i.v. route in patients receiving chemotherapy.
Fifty-nine patients treated with "once every 2 weeks" regimens received 1000 mg of amifostine i.v. before chemotherapy. Patients who developed protracted vomiting and malaise and/or clinical hypotension for two consecutive i.v. administrations received the same dose of amifostine s.c. for the subsequent cycles (i.v./s.c. study). In an additional cohort of 12 patients (s.c. study), 1000 mg of amifostine were given s.c. since the first chemotherapy cycle.
In the i.v./s.c. study, 8 (13.5%) patients showed protracted emesis/malaise and/or clinical hypotension during the first two cycles. An additional 4 (6.6%) patients developed similar side effects during the subsequent cycles. Switching to the s.c. route, an improved tolerance was noted. In the s.c. study, a total of 76 injections was administered. Protracted vomiting or clinical hypotension was absent, and this tolerance profile was significantly better than the i.v. one (P = 0.001). There were no other systemic side effects related to the s.c. administration.
Amifostine, at a dose of 1000 mg, is better tolerated when administered s.c. Switching to the s.c. route in patients with poor tolerance using the i.v. administration allows the continuation of cytoprotection with minor side effects. Although preliminary, 1000 mg of amifostine effectively protected against the lower, still more frequently administered doses of chemotherapy given once every 2 weeks. |
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Fifty-nine patients treated with "once every 2 weeks" regimens received 1000 mg of amifostine i.v. before chemotherapy. Patients who developed protracted vomiting and malaise and/or clinical hypotension for two consecutive i.v. administrations received the same dose of amifostine s.c. for the subsequent cycles (i.v./s.c. study). In an additional cohort of 12 patients (s.c. study), 1000 mg of amifostine were given s.c. since the first chemotherapy cycle.
In the i.v./s.c. study, 8 (13.5%) patients showed protracted emesis/malaise and/or clinical hypotension during the first two cycles. An additional 4 (6.6%) patients developed similar side effects during the subsequent cycles. Switching to the s.c. route, an improved tolerance was noted. In the s.c. study, a total of 76 injections was administered. Protracted vomiting or clinical hypotension was absent, and this tolerance profile was significantly better than the i.v. one (P = 0.001). There were no other systemic side effects related to the s.c. administration.
Amifostine, at a dose of 1000 mg, is better tolerated when administered s.c. Switching to the s.c. route in patients with poor tolerance using the i.v. administration allows the continuation of cytoprotection with minor side effects. Although preliminary, 1000 mg of amifostine effectively protected against the lower, still more frequently administered doses of chemotherapy given once every 2 weeks.</description><identifier>ISSN: 1078-0432</identifier><identifier>EISSN: 1557-3265</identifier><identifier>PMID: 12960114</identifier><language>eng</language><publisher>Philadelphia, PA: American Association for Cancer Research</publisher><subject>Adult ; Aged ; Amifostine - administration & dosage ; Amifostine - therapeutic use ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Biological and medical sciences ; Chemotherapy ; Drug Administration Routes ; Female ; Humans ; Infusions, Intravenous ; Injections, Subcutaneous ; Male ; Medical sciences ; Middle Aged ; Neoplasms - drug therapy ; Pharmacology. Drug treatments ; Radiation-Protective Agents - administration & dosage ; Radiation-Protective Agents - therapeutic use ; Vomiting - drug therapy</subject><ispartof>Clinical cancer research, 2003-08, Vol.9 (9), p.3288-3293</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15106519$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12960114$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KOUKOURAKIS, Michael I</creatorcontrib><creatorcontrib>SIMOPOULOS, Costantinos</creatorcontrib><creatorcontrib>MINOPOULOS, George</creatorcontrib><creatorcontrib>PATLAKAS, George</creatorcontrib><creatorcontrib>POLYCHRONIDIS, Alexandros</creatorcontrib><creatorcontrib>LIMBERIS, Vassilis</creatorcontrib><creatorcontrib>ROMANIDES, Kostantinos</creatorcontrib><creatorcontrib>PITIACOUDIS, Michael</creatorcontrib><creatorcontrib>MANOLAS, Costantinos</creatorcontrib><title>Amifostine before chemotherapy: Improved tolerance profile of the subcutaneous over the intravenous route</title><title>Clinical cancer research</title><addtitle>Clin Cancer Res</addtitle><description>The i.v. administration of the cytoprotective agent amifostine is associated with reversible clinical hypotension, protracted emesis, and malaise in a various percentage of patients. We evaluated, prospectively, whether the s.c. route is a better tolerated alternative to the i.v. route in patients receiving chemotherapy.
Fifty-nine patients treated with "once every 2 weeks" regimens received 1000 mg of amifostine i.v. before chemotherapy. Patients who developed protracted vomiting and malaise and/or clinical hypotension for two consecutive i.v. administrations received the same dose of amifostine s.c. for the subsequent cycles (i.v./s.c. study). In an additional cohort of 12 patients (s.c. study), 1000 mg of amifostine were given s.c. since the first chemotherapy cycle.
In the i.v./s.c. study, 8 (13.5%) patients showed protracted emesis/malaise and/or clinical hypotension during the first two cycles. An additional 4 (6.6%) patients developed similar side effects during the subsequent cycles. Switching to the s.c. route, an improved tolerance was noted. In the s.c. study, a total of 76 injections was administered. Protracted vomiting or clinical hypotension was absent, and this tolerance profile was significantly better than the i.v. one (P = 0.001). There were no other systemic side effects related to the s.c. administration.
Amifostine, at a dose of 1000 mg, is better tolerated when administered s.c. Switching to the s.c. route in patients with poor tolerance using the i.v. administration allows the continuation of cytoprotection with minor side effects. Although preliminary, 1000 mg of amifostine effectively protected against the lower, still more frequently administered doses of chemotherapy given once every 2 weeks.</description><subject>Adult</subject><subject>Aged</subject><subject>Amifostine - administration & dosage</subject><subject>Amifostine - therapeutic use</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy</subject><subject>Drug Administration Routes</subject><subject>Female</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Injections, Subcutaneous</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasms - drug therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Radiation-Protective Agents - administration & dosage</subject><subject>Radiation-Protective Agents - therapeutic use</subject><subject>Vomiting - drug therapy</subject><issn>1078-0432</issn><issn>1557-3265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNpFkE1LxDAQhoso7rr6FyQXvRWSJmlSb8vix8KCFz2XNJ2wkbapSbqw_96sW_E0Mw8PwztzkS0J5yKnRckvU4-FzDGjxSK7CeELY8IIZtfZghRViQlhy8yue2tciHYA1IBxHpDeQ-_iHrwaj09o24_eHaBF0XUJDRpQAsZ2gJxBSUNhavQU1QBuCiip_pfaIXp1gOEEvZsi3GZXRnUB7ua6yj5fnj82b_nu_XW7We_ysaAi5qpqRMVIRQpGmJGm1ZgoLoGyhutGKkIlFVQ0vFSK8zRgjgkVmKkKWoCKrrLH894U83uCEOveBg1dd05YC8pZKZlM4v0sTk0PbT162yt_rP-ek4SHWVBBq86crrfh3-MEl5xU9AfQVW-w</recordid><startdate>20030815</startdate><enddate>20030815</enddate><creator>KOUKOURAKIS, Michael I</creator><creator>SIMOPOULOS, Costantinos</creator><creator>MINOPOULOS, George</creator><creator>PATLAKAS, George</creator><creator>POLYCHRONIDIS, Alexandros</creator><creator>LIMBERIS, Vassilis</creator><creator>ROMANIDES, Kostantinos</creator><creator>PITIACOUDIS, Michael</creator><creator>MANOLAS, Costantinos</creator><general>American Association for Cancer Research</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20030815</creationdate><title>Amifostine before chemotherapy: Improved tolerance profile of the subcutaneous over the intravenous route</title><author>KOUKOURAKIS, Michael I ; SIMOPOULOS, Costantinos ; MINOPOULOS, George ; PATLAKAS, George ; POLYCHRONIDIS, Alexandros ; LIMBERIS, Vassilis ; ROMANIDES, Kostantinos ; PITIACOUDIS, Michael ; MANOLAS, Costantinos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p237t-a9b7941912414f8fdc01a58e34b5cb8a1383737b56aa5538305013704a9edee93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Amifostine - administration & dosage</topic><topic>Amifostine - therapeutic use</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy</topic><topic>Drug Administration Routes</topic><topic>Female</topic><topic>Humans</topic><topic>Infusions, Intravenous</topic><topic>Injections, Subcutaneous</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasms - drug therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Radiation-Protective Agents - administration & dosage</topic><topic>Radiation-Protective Agents - therapeutic use</topic><topic>Vomiting - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KOUKOURAKIS, Michael I</creatorcontrib><creatorcontrib>SIMOPOULOS, Costantinos</creatorcontrib><creatorcontrib>MINOPOULOS, George</creatorcontrib><creatorcontrib>PATLAKAS, George</creatorcontrib><creatorcontrib>POLYCHRONIDIS, Alexandros</creatorcontrib><creatorcontrib>LIMBERIS, Vassilis</creatorcontrib><creatorcontrib>ROMANIDES, Kostantinos</creatorcontrib><creatorcontrib>PITIACOUDIS, Michael</creatorcontrib><creatorcontrib>MANOLAS, Costantinos</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical cancer research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KOUKOURAKIS, Michael I</au><au>SIMOPOULOS, Costantinos</au><au>MINOPOULOS, George</au><au>PATLAKAS, George</au><au>POLYCHRONIDIS, Alexandros</au><au>LIMBERIS, Vassilis</au><au>ROMANIDES, Kostantinos</au><au>PITIACOUDIS, Michael</au><au>MANOLAS, Costantinos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Amifostine before chemotherapy: Improved tolerance profile of the subcutaneous over the intravenous route</atitle><jtitle>Clinical cancer research</jtitle><addtitle>Clin Cancer Res</addtitle><date>2003-08-15</date><risdate>2003</risdate><volume>9</volume><issue>9</issue><spage>3288</spage><epage>3293</epage><pages>3288-3293</pages><issn>1078-0432</issn><eissn>1557-3265</eissn><abstract>The i.v. administration of the cytoprotective agent amifostine is associated with reversible clinical hypotension, protracted emesis, and malaise in a various percentage of patients. We evaluated, prospectively, whether the s.c. route is a better tolerated alternative to the i.v. route in patients receiving chemotherapy.
Fifty-nine patients treated with "once every 2 weeks" regimens received 1000 mg of amifostine i.v. before chemotherapy. Patients who developed protracted vomiting and malaise and/or clinical hypotension for two consecutive i.v. administrations received the same dose of amifostine s.c. for the subsequent cycles (i.v./s.c. study). In an additional cohort of 12 patients (s.c. study), 1000 mg of amifostine were given s.c. since the first chemotherapy cycle.
In the i.v./s.c. study, 8 (13.5%) patients showed protracted emesis/malaise and/or clinical hypotension during the first two cycles. An additional 4 (6.6%) patients developed similar side effects during the subsequent cycles. Switching to the s.c. route, an improved tolerance was noted. In the s.c. study, a total of 76 injections was administered. Protracted vomiting or clinical hypotension was absent, and this tolerance profile was significantly better than the i.v. one (P = 0.001). There were no other systemic side effects related to the s.c. administration.
Amifostine, at a dose of 1000 mg, is better tolerated when administered s.c. Switching to the s.c. route in patients with poor tolerance using the i.v. administration allows the continuation of cytoprotection with minor side effects. Although preliminary, 1000 mg of amifostine effectively protected against the lower, still more frequently administered doses of chemotherapy given once every 2 weeks.</abstract><cop>Philadelphia, PA</cop><pub>American Association for Cancer Research</pub><pmid>12960114</pmid><tpages>6</tpages></addata></record> |
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subjects | Adult Aged Amifostine - administration & dosage Amifostine - therapeutic use Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - administration & dosage Biological and medical sciences Chemotherapy Drug Administration Routes Female Humans Infusions, Intravenous Injections, Subcutaneous Male Medical sciences Middle Aged Neoplasms - drug therapy Pharmacology. Drug treatments Radiation-Protective Agents - administration & dosage Radiation-Protective Agents - therapeutic use Vomiting - drug therapy |
title | Amifostine before chemotherapy: Improved tolerance profile of the subcutaneous over the intravenous route |
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