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. 1997;76(5):639–642. doi: 10.1038/bjc.1997.438

Outpatient treatment with epirubicin and oral etoposide in patients with small-cell lung cancer.

H Gogas 1, F J Lofts 1, T R Evans 1, F J Millard 1, R Wilson 1, J L Mansi 1
PMCID: PMC2228002  PMID: 9303364

Abstract

To assess the efficacy and toxicity of an outpatient combination chemotherapy in small-cell lung cancer (SCLC), we treated 70 consecutive patients with epirubicin 80 mg m(-2) i.v. on day 1 and etoposide 200 mg o.d. p.o. on days 1-4 (EE) at 3-weekly intervals. The median age of patients was 64 years (range 39-84). The male-female ratio was 42:28 and 35 (50%) had metastatic disease. Fifty-seven patients were evaluable for response. The overall response rate was 64.4%, including 14 (23.7%) complete responses and 24 (40.7%) partial responses. Median time to progression was 7 months in responders and 8 months in patients with limited disease. The median survival in patients with limited disease was 10.5 months (range 0.5-70 +) and 7 months (range 0.5-24) in those with extensive disease. Improvement of symptoms occurred in 79% of patients with shortness of breath, 80% with cough, 81% with haemoptysis and 68% with pain. In 19 patients an increase in body weight was noted. Major (WHO grade 3/4) toxicities were neutropenia in 13 (18.5%) patients, alopecia in 33 (47.1%) patients, mucositis in 15 (21.4%) patients, anorexia in eight patients (11.4%), nausea and vomiting in six patients (8.5%) and diarrhoea in 4 (5.7%) patients. In conclusion, EE is an active and well-tolerated outpatient regimen in the treatment of SCLC. The survival data in this unselected group of patients were disappointing and the possible explanations for this are discussed.

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Selected References

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  1. Abratt R. P., Willcox P. A., Hewitson R. H. Etoposide combination therapy for small cell carcinoma of the lung. Cancer Chemother Pharmacol. 1987;20(1):83–84. doi: 10.1007/BF00252967. [DOI] [PubMed] [Google Scholar]
  2. Albain K. S., Crowley J. J., LeBlanc M., Livingston R. B. Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient Southwest Oncology Group data base. J Clin Oncol. 1990 Sep;8(9):1563–1574. doi: 10.1200/JCO.1990.8.9.1563. [DOI] [PubMed] [Google Scholar]
  3. Bamberga M., Michetti G., Bamberga P., Ori-Belometti M., Gritti G., Sarti E., Villa R. Cyclophosphamide, epirubicin, etoposide, cis platinum (CEVP) in combination with radiotherapy: evaluation of a protocol adopted for 6 years in 148 cases of small cell lung cancer. Tumori. 1992 Oct 31;78(5):333–337. doi: 10.1177/030089169207800509. [DOI] [PubMed] [Google Scholar]
  4. Blackstein M., Eisenhauer E. A., Wierzbicki R., Yoshida S. Epirubicin in extensive small-cell lung cancer: a phase II study in previously untreated patients: a National Cancer Institute of Canada Clinical Trials Group Study. J Clin Oncol. 1990 Mar;8(3):385–389. doi: 10.1200/JCO.1990.8.3.385. [DOI] [PubMed] [Google Scholar]
  5. Eckhardt S., Kolaric K., Vukas D., Kánitz E., Schoket Z., Jassem J., Vuletic L., Jelic S., Mechl Z., Koza I. Phase II study of 4'-epi-doxorubicin in patients with untreated, extensive small cell lung cancer. South-East European Oncology Group (SEEOG). Med Oncol Tumor Pharmacother. 1990;7(1):19–23. [PubMed] [Google Scholar]
  6. Evans W. K., Radwi A., Tomiak E., Logan D. M., Martins H., Stewart D. J., Goss G., Maroun J. A., Dahrouge S. Oral etoposide and carboplatin. Effective therapy for elderly patients with small cell lung cancer. Am J Clin Oncol. 1995 Apr;18(2):149–155. [PubMed] [Google Scholar]
  7. Hansen H. H. Management of small-cell cancer of the lung. Lancet. 1992 Apr 4;339(8797):846–849. doi: 10.1016/0140-6736(92)90287-d. [DOI] [PubMed] [Google Scholar]
  8. Klastersky J. Small cell lung cancer: can treatment results be improved further? Semin Oncol. 1995 Feb;22(1 Suppl 2):1–2. [PubMed] [Google Scholar]
  9. Loehrer P. J., Sr, Ansari R., Gonin R., Monaco F., Fisher W., Sandler A., Einhorn L. H. Cisplatin plus etoposide with and without ifosfamide in extensive small-cell lung cancer: a Hoosier Oncology Group study. J Clin Oncol. 1995 Oct;13(10):2594–2599. doi: 10.1200/JCO.1995.13.10.2594. [DOI] [PubMed] [Google Scholar]
  10. Loehrer P. J., Sr Palliative therapy: extensive small cell lung cancer. Semin Oncol. 1995 Apr;22(2 Suppl 3):40–44. [PubMed] [Google Scholar]
  11. Macchiarini P., Chella A., Riva A., Mengozzi G., Silvano G., Solfanelli S., Angeletti C. A. Phase II feasibility study of high dose epirubicin-based regimens for untreated patients with small-cell lung cancer. Am J Clin Oncol. 1990 Dec;13(6):495–500. doi: 10.1097/00000421-199012000-00009. [DOI] [PubMed] [Google Scholar]
  12. Macchiarini P., Danesi R., Mariotti R., Marchetti A., Fazzi P., Bevilacqua G., Mariani M., Giuntini C., Del Tacca M., Angeletti C. A. Phase II study of high-dose epirubicin in untreated patients with small-cell lung cancer. Am J Clin Oncol. 1990 Aug;13(4):302–307. doi: 10.1097/00000421-199008000-00007. [DOI] [PubMed] [Google Scholar]
  13. Pedersen A. G., Hansen H. H. Etoposide (VP-16) in the treatment of lung cancer. Cancer Treat Rev. 1983 Dec;10(4):245–264. doi: 10.1016/0305-7372(83)90013-0. [DOI] [PubMed] [Google Scholar]
  14. Pfeiffer P., Sørensen P., Rose C. Is carboplatin and oral etoposide an effective and feasible regimen in patients with small cell lung cancer? Eur J Cancer. 1995;31A(1):64–69. doi: 10.1016/0959-8049(94)00370-k. [DOI] [PubMed] [Google Scholar]
  15. Plosker G. L., Faulds D. Epirubicin. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cancer chemotherapy. Drugs. 1993 May;45(5):788–856. doi: 10.2165/00003495-199345050-00011. [DOI] [PubMed] [Google Scholar]
  16. Rosell R., Carles J., Abad A., Jimeno J. M., Moreno I., Barnadas A., Ribelles N., Haboubi N. Phase II feasibility study of high dose epirubicin plus etoposide and cisplatin (HDEEC) regimen in small cell lung cancer. Invest New Drugs. 1992 Jul;10(2):123–128. doi: 10.1007/BF00873130. [DOI] [PubMed] [Google Scholar]
  17. Sculier J. P., Bureau G., Giner V., Thiriaux J., Michel J., Berchier M. C., Van Cutsem O., Küstner U., Kroll F., Mommen P. Induction chemotherapy with ifosfamide, etoposide, and anthracycline for small cell lung cancer: experience of the European Lung Cancer Working Party. Semin Oncol. 1995 Feb;22(1 Suppl 2):18–22. [PubMed] [Google Scholar]
  18. Slevin M. L., Clark P. I., Joel S. P., Malik S., Osborne R. J., Gregory W. M., Lowe D. G., Reznek R. H., Wrigley P. F. A randomized trial to evaluate the effect of schedule on the activity of etoposide in small-cell lung cancer. J Clin Oncol. 1989 Sep;7(9):1333–1340. doi: 10.1200/JCO.1989.7.9.1333. [DOI] [PubMed] [Google Scholar]
  19. Wolff A. C., Ettinger D. S., Neuberg D., Comis R. L., Ruckdeschel J. C., Bonomi P. D., Johnson D. H. Phase II study of ifosfamide, carboplatin, and oral etoposide chemotherapy for extensive-disease small-cell lung cancer: an Eastern Cooperative Oncology Group pilot study. J Clin Oncol. 1995 Jul;13(7):1615–1622. doi: 10.1200/JCO.1995.13.7.1615. [DOI] [PubMed] [Google Scholar]

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