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Cisplatin - Etoposide regimen
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Lung Cancer |
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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 |
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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
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