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Cisplatin - Etoposide regimen

Abstract: Combination chemotherapy with cisplatin and etoposide in bronchogenic squamous cell carcinoma and adenocarcinoma. A study by the EORTC lung cancer working party (Belgium).

Cisplatin and etoposide combination was used in 94 patients with measurable or evaluable bronchogenic squamous cell carcinoma or adenocarcinoma. The overall response rate was 38% with four complete remission (CR). In patients with locoregional disease who did not receive any prior anticancer therapy the response rate was 56% (19/34) with three CR, significantly (P = 0.02) higher than that observed in the other patients (28%). The overall median duration of response was 36.7 weeks. Patients with locoregional disease who did not receive any prior anticancer therapy had a median duration of response of 43.6 weeks; longer than that (27.5 weeks) in the other patients. Overall, responding patients survived significantly longer (P less than 0.0001) than non responders (median survival 60.0 weeks versus 23.0). Toxicity was tolerable; gastrointestinal side effects were occasionally responsible for discontinuation of therapy and sepsis was the cause of death in two neutropenic patients. No serious nephrotoxicity was observed. The combination of cisplatin and etoposide should probably be tested in combination with surgery of radiotherapy.

References

Longeval E, Klastersky J. Combination chemotherapy with cisplatin and etoposide in bronchogenic squamous cell carcinoma and adenocarcinoma. A study by the EORTC lung cancer working party (Belgium). Cancer. 1982 Dec 15;50(12):2751-6.

Non-Small Cell Lung Cancer Collaborative Group. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small Cell Lung Cancer Collaborative Group. BMJ. 1995 Oct 7;311(7010):899-909. (Author Note: This study was crucial in determining the role of cisplatin based regimens in the treatment of non-small cell lung cancer).

Weick JK, Crowley J, Natale RB, et al.: A randomized trial of five cisplatin-containing treatments in patients with metastatic non-small-cell lung cancer: a Southwest Oncology Group study. Journal of Clinical Oncology 9(7): 1157-1162, 1991. (Author Note: This prospective randomized trial compared 5 older cisplatin-containing regimens and showed no significant difference in response, duration of response, or survival among the different cisplatin-based regimens).

Klastersky J, Sculier JP, Lacroix H, Dabouis G, Bureau G, Libert P, Richez M, Ravez P, Vandermoten G, Thiriaux J, et al. A randomized study comparing cisplatin or carboplatin with etoposide in patients with advanced non-small-cell lung cancer: European Organization for Research and Treatment of Cancer Protocol 07861. J Clin Oncol. 1990 Sep;8(9):1556-62. (Author Note: This study that cisplatin - etoposide was more active than carboplatin - etoposide in the treatment of non-small cell lung cancer).

Bonomi PD, Finkelstein DM, Ruckdeschel JC, et al. Combination chemotherapy versus single agents followed by combination chemotherapy in stage IV non-small-cell lung cancer: a study of the Eastern Cooperative Oncology Group. J Clin Oncol. 1989;7:1602-1613. (Author Note: This study provided evidence that combination chemotherapy was superior to single agent regimens in the treatment of non-small cell lung cancer).

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Regimen

Etoposide....... 100 mg / M2 IV days 1 - 3
Cisplatin....... 100 mg / M2 IV day 1
FREQUENCY every 21 - 28 days

- there are multiple variants of this regimen


     
  Summary  
  Overall Response Rate  
  Progression Free Survival  
  Overall Survival  
  Toxicity  
     

Article reviewed by:

Dr. Tamer Fouad, M.D.

 

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