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MK-0457 demonstratedemonstratedficacy and only at higher, intolerable doses; lower doses were tolerated and no unexpected toxicities were observed.
The typical malformations seen from intolerable doses of small molecular TRKIs included pericardial and yolk-sac oedema, altered architecture of the dorsal and caudal fins, and also short anterior-posterior body axis.
Patients who do not respond to medical therapies, who relapse after response to therapies, or who require potentially intolerable doses of medical therapies to achieve platelet counts high enough to prevent bleeding usually undergo splenectomy, if the patient is a suitable candidate [ 11].
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> -wrap-foot> If toxicity is tolerable, no dose adjustment required If toxicity becomes intolerable, temporary dose interruption until recovery to grade ≤1.
Intolerable dosage was defined as two or more out of six patients experiencing DLT and then the immediate lower dose level was considered as the maximum tolerated dose.
To establish partial response, a POTS II pharmacotherapist considered the following (see Figure 1): 1) Adequate trial at or above the minimum starting dose; 2) Maximum dose; 3) Intolerable side effects at a dose above his or her current dose; 4) Stable current dose for 3 weeks; 5) Minimum of 9 weeks of treatment.
If the daily dose of S-1 was considered to be intolerable, the retreatment dose was reduced by 20 mg day−1 (minimum dose, 80 mg day−1).
If the toxicity occurred in two or more patients at a single dose level, then that dose was deemed intolerable and the next lower dose level was expanded to increase confidence in toxicity assessment at the MTD.
Treatment was discontinued if there was evidence of disease progression, intolerable toxicity despite dose reductions, completion of six cycles of chemotherapy with best response being only stable disease, or at the patient's request.
If a dose increase resulted in intolerable side effects, the dose could be reduced to the previously tolerated level.
In case of intolerable adverse events, lower doses were administered, followed by increased doses once participants recovered from the adverse event.
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