Extensive-stage small-cell bronchogenic carcinoma

Intensive induction chemotherapy with high-dose cyclophosphamide plus high-dose etoposide

D. H. Johnson, S. N. Wolff, J. D. Hainsworth, L. L. Porter, W. W. Grosh, K. R. Hande, F. A. Greco

Research output: Contribution to journalArticle

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Abstract

Seventeen ambulatory patients with extensive-stage small-cell lung cancer received one or two courses of high-dose induction chemotherapy consisting of cyclophosphamide (100 mg/kg) plus etopside (1,200 mg/m2) followed by four or five cycles of conventional-dose cyclophosphamide (1,000 mg/m2), doxorubicin (40 mg/m2), and vincristine (1.4 mg/m2) (CAV) given every 21 days. No additional chemotherapy was given until relapse or progression was documented. Response was assessed initially after high-dose induction therapy and again after completion of all chemotherapy. After induction therapy, 16/17 (94%) patients had achieved an objective response, including five (29%) complete responses and 11 (65%) partial responses. Two partially responding patients improved to a complete response after CAV, while one partial responder progressed and one patient died of an intercurrent illness while receiving CAV. Thus, the overall response after completing all chemotherapy was 15/16 (94%), including seven (44%) complete responses and eight (50%) partial responses. Median response duration was six months (range, 3 to 11 months), and overall median survival was ten months (range, 2 to 17 months). All 31 courses of induction therapy were associated with leukopenia (<1,000/μL), 81% with thrombocytopenia (<20,000/μL), and 77% with fever (>38.5° C). Seven episodes of bacteremia and one axillary abscess were documented, and there was one treatment-related death (6%). These toxicities are similar to that produced by high-dose etoposide alone. High-dose cyclophosphamide combined with high-dose etoposide can be administered to ambulatory patients with extensive-stage small-cell lung cancer without requiring bone marrow transplantation to reestablish hematopoiesis. Complete response and median survival rates, however, are similar to those obtained with less intensive therapy.

Original languageEnglish (US)
Pages (from-to)170-175
Number of pages6
JournalJournal of Clinical Oncology
Volume3
Issue number2
StatePublished - 1985

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Induction Chemotherapy
Small Cell Carcinoma
Bronchogenic Carcinoma
Etoposide
Cyclophosphamide
Small Cell Lung Carcinoma
Drug Therapy
Therapeutics
Hematopoiesis
Leukopenia
Vincristine
Bacteremia
Bone Marrow Transplantation
Doxorubicin
Abscess
Survival Rate
Recurrence
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Extensive-stage small-cell bronchogenic carcinoma : Intensive induction chemotherapy with high-dose cyclophosphamide plus high-dose etoposide. / Johnson, D. H.; Wolff, S. N.; Hainsworth, J. D.; Porter, L. L.; Grosh, W. W.; Hande, K. R.; Greco, F. A.

In: Journal of Clinical Oncology, Vol. 3, No. 2, 1985, p. 170-175.

Research output: Contribution to journalArticle

Johnson, D. H. ; Wolff, S. N. ; Hainsworth, J. D. ; Porter, L. L. ; Grosh, W. W. ; Hande, K. R. ; Greco, F. A. / Extensive-stage small-cell bronchogenic carcinoma : Intensive induction chemotherapy with high-dose cyclophosphamide plus high-dose etoposide. In: Journal of Clinical Oncology. 1985 ; Vol. 3, No. 2. pp. 170-175.
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title = "Extensive-stage small-cell bronchogenic carcinoma: Intensive induction chemotherapy with high-dose cyclophosphamide plus high-dose etoposide",
abstract = "Seventeen ambulatory patients with extensive-stage small-cell lung cancer received one or two courses of high-dose induction chemotherapy consisting of cyclophosphamide (100 mg/kg) plus etopside (1,200 mg/m2) followed by four or five cycles of conventional-dose cyclophosphamide (1,000 mg/m2), doxorubicin (40 mg/m2), and vincristine (1.4 mg/m2) (CAV) given every 21 days. No additional chemotherapy was given until relapse or progression was documented. Response was assessed initially after high-dose induction therapy and again after completion of all chemotherapy. After induction therapy, 16/17 (94{\%}) patients had achieved an objective response, including five (29{\%}) complete responses and 11 (65{\%}) partial responses. Two partially responding patients improved to a complete response after CAV, while one partial responder progressed and one patient died of an intercurrent illness while receiving CAV. Thus, the overall response after completing all chemotherapy was 15/16 (94{\%}), including seven (44{\%}) complete responses and eight (50{\%}) partial responses. Median response duration was six months (range, 3 to 11 months), and overall median survival was ten months (range, 2 to 17 months). All 31 courses of induction therapy were associated with leukopenia (<1,000/μL), 81{\%} with thrombocytopenia (<20,000/μL), and 77{\%} with fever (>38.5° C). Seven episodes of bacteremia and one axillary abscess were documented, and there was one treatment-related death (6{\%}). These toxicities are similar to that produced by high-dose etoposide alone. High-dose cyclophosphamide combined with high-dose etoposide can be administered to ambulatory patients with extensive-stage small-cell lung cancer without requiring bone marrow transplantation to reestablish hematopoiesis. Complete response and median survival rates, however, are similar to those obtained with less intensive therapy.",
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T2 - Intensive induction chemotherapy with high-dose cyclophosphamide plus high-dose etoposide

AU - Johnson, D. H.

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AU - Hainsworth, J. D.

AU - Porter, L. L.

AU - Grosh, W. W.

AU - Hande, K. R.

AU - Greco, F. A.

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