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Alternating chemotherapy with etoposide plus cisplatin and topotecan plus paclitaxel in patients with untreated, extensive-stage small cell lung carcinoma: a phase II trial of the North Central Cancer Treatment Group.
Cancer. 2003 May 15; 97(10):2498-503.C

Abstract

BACKGROUND

The objective of this study was to test the response rate and toxicity of alternating chemotherapy in previously untreated patients with extensive-stage small cell lung carcinoma (SCLC).

METHODS

Patients with histologically proven, extensive-stage SCLC, with a performance status of 0-2, and who had received no prior chemotherapy were eligible. The design was a two-stage, Phase II, multicenter trial. Treatment consisted of alternating chemotherapy every 3 weeks with etoposide (100 mg/m(2) on Days 1-3) and cisplatin (30 mg/m(2) on Days 1-3) on Cycles 1, 3, 5 and with topotecan (1 mg/m(2) on Days 1-5) and paclitaxel (200 mg/m(2) on Day 5) on Cycles 2, 4, and 6. Filgrastim support was given with Cycles 2, 4, 6.

RESULTS

Forty-four patients were eligible and evaluable. The primary toxicity was myelosuppression. The median absolute neutrophil count was 300/microL with 70% Grade 4 neutropenia. The median platelet count was 58,000/microL with 23% Grade 4 thrombocytopenia. Grade 4 nonhematologic toxicities occurred in 16% of patients. Overall toxicities were not different between the two regimens. There were no treatment-related deaths. Complete or partial responses occurred in 34 patients (77%). The median time to progression was 6.9 months, with a median survival of 10.5 months and with 1-year and 2-year survival rates of 37% and 12%, respectively.

CONCLUSIONS

The regimen of alternating chemotherapy was associated with substantial myelosuppression and resulted in a high response rate and good overall survival. The results were similar to those reported in prior trials and did not suggest any improvement in therapy for patients with SCLC.

Authors+Show Affiliations

Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. jett.james@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Clinical Trial, Phase II
Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12733149

Citation

Jett, James R., et al. "Alternating Chemotherapy With Etoposide Plus Cisplatin and Topotecan Plus Paclitaxel in Patients With Untreated, Extensive-stage Small Cell Lung Carcinoma: a Phase II Trial of the North Central Cancer Treatment Group." Cancer, vol. 97, no. 10, 2003, pp. 2498-503.
Jett JR, Hatfield AK, Hillman S, et al. Alternating chemotherapy with etoposide plus cisplatin and topotecan plus paclitaxel in patients with untreated, extensive-stage small cell lung carcinoma: a phase II trial of the North Central Cancer Treatment Group. Cancer. 2003;97(10):2498-503.
Jett, J. R., Hatfield, A. K., Hillman, S., Bauman, M. D., Mailliard, J. A., Kugler, J. W., Morton, R. F., Marks, R. S., & Levitt, R. (2003). Alternating chemotherapy with etoposide plus cisplatin and topotecan plus paclitaxel in patients with untreated, extensive-stage small cell lung carcinoma: a phase II trial of the North Central Cancer Treatment Group. Cancer, 97(10), 2498-503.
Jett JR, et al. Alternating Chemotherapy With Etoposide Plus Cisplatin and Topotecan Plus Paclitaxel in Patients With Untreated, Extensive-stage Small Cell Lung Carcinoma: a Phase II Trial of the North Central Cancer Treatment Group. Cancer. 2003 May 15;97(10):2498-503. PubMed PMID: 12733149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alternating chemotherapy with etoposide plus cisplatin and topotecan plus paclitaxel in patients with untreated, extensive-stage small cell lung carcinoma: a phase II trial of the North Central Cancer Treatment Group. AU - Jett,James R, AU - Hatfield,Alan K, AU - Hillman,Shauna, AU - Bauman,Michael D, AU - Mailliard,James A, AU - Kugler,John W, AU - Morton,Roscoe F, AU - Marks,Randolph S, AU - Levitt,Ralph, PY - 2003/5/7/pubmed PY - 2003/5/23/medline PY - 2003/5/7/entrez SP - 2498 EP - 503 JF - Cancer JO - Cancer VL - 97 IS - 10 N2 - BACKGROUND: The objective of this study was to test the response rate and toxicity of alternating chemotherapy in previously untreated patients with extensive-stage small cell lung carcinoma (SCLC). METHODS: Patients with histologically proven, extensive-stage SCLC, with a performance status of 0-2, and who had received no prior chemotherapy were eligible. The design was a two-stage, Phase II, multicenter trial. Treatment consisted of alternating chemotherapy every 3 weeks with etoposide (100 mg/m(2) on Days 1-3) and cisplatin (30 mg/m(2) on Days 1-3) on Cycles 1, 3, 5 and with topotecan (1 mg/m(2) on Days 1-5) and paclitaxel (200 mg/m(2) on Day 5) on Cycles 2, 4, and 6. Filgrastim support was given with Cycles 2, 4, 6. RESULTS: Forty-four patients were eligible and evaluable. The primary toxicity was myelosuppression. The median absolute neutrophil count was 300/microL with 70% Grade 4 neutropenia. The median platelet count was 58,000/microL with 23% Grade 4 thrombocytopenia. Grade 4 nonhematologic toxicities occurred in 16% of patients. Overall toxicities were not different between the two regimens. There were no treatment-related deaths. Complete or partial responses occurred in 34 patients (77%). The median time to progression was 6.9 months, with a median survival of 10.5 months and with 1-year and 2-year survival rates of 37% and 12%, respectively. CONCLUSIONS: The regimen of alternating chemotherapy was associated with substantial myelosuppression and resulted in a high response rate and good overall survival. The results were similar to those reported in prior trials and did not suggest any improvement in therapy for patients with SCLC. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/12733149/Alternating_chemotherapy_with_etoposide_plus_cisplatin_and_topotecan_plus_paclitaxel_in_patients_with_untreated_extensive_stage_small_cell_lung_carcinoma:_a_phase_II_trial_of_the_North_Central_Cancer_Treatment_Group_ L2 - https://doi.org/10.1002/cncr.11377 DB - PRIME DP - Unbound Medicine ER -