Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer: A phase II trial

David H. Johnson, F. Anthony Greco, John Strupp, Kenneth R. Hande, John D. Hainsworth

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Twenty-two patients with recurrent small-cell lung cancer (SCLC) were treated with single-agent etoposide 50 mg/m2/d by mouth for 21 consecutive days. Eleven patients had received previous chemotherapy with cyclophosphamide, doxorubicin, and vincristine (CAV) or etoposide (CAE) or both (CAVE). Four of the latter patients also received salvage treatment with cisplatin and etoposide (EP). Nine patients had been treated with EP as induction therapy, while two patients had received high-dose cyclophosphamide, etoposide and cisplatin (HDCEP). Altogether, 18 patients had received previous intravenous etoposide. The median time off chemotherapy was 4.5 months (range, 1 to 28.9 months). Ten patients (45.5%; 95% confidence interval [Cl], 27% to 65%) achieved a complete or partial response. Responses were most common in patients who had responded to previous chemotherapy and who had not received any treatment in the 90 days before initiation of oral etoposide. Median response duration was 4 months (range, 1.5 to 9.5 months) and median survival was 3.5 + months (range, 1.0 to 15+ months). Leukocyte and platelet nadirs were 1,800/μL and 160,000/μL, respectively, during cycle 1 of treatment and occurred between days 21 and 28. Overall, total leukocyte count decreased to less than 1,000/μL during 10 of 56 cycles (18%). Five patients required six hospitalizations for neutropenia and fever. There were two toxic deaths due to sepsis. Platelet counts less than 50,000/μL occurred in 14 cycles (25%). Alopecia developed in all patients; gastrointestinal toxicity was uncommon. This schedule of etoposide administration warrants further study in combination with other active agents in previously untreated patients with SCLC. J Clin Oncol 8:1613-1617.

Original languageEnglish (US)
Pages (from-to)1613-1617
Number of pages5
JournalJournal of Clinical Oncology
Volume8
Issue number10
StatePublished - Oct 1990

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Small Cell Lung Carcinoma
Etoposide
Oral Administration
Drug Therapy
Cyclophosphamide
Cisplatin
Salvage Therapy
Poisons
Alopecia
Vincristine
Neutropenia
Platelet Count
Leukocyte Count
Doxorubicin
Mouth
Sepsis
Appointments and Schedules
Hospitalization
Leukocytes
Fever

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer : A phase II trial. / Johnson, David H.; Greco, F. Anthony; Strupp, John; Hande, Kenneth R.; Hainsworth, John D.

In: Journal of Clinical Oncology, Vol. 8, No. 10, 10.1990, p. 1613-1617.

Research output: Contribution to journalArticle

Johnson, David H. ; Greco, F. Anthony ; Strupp, John ; Hande, Kenneth R. ; Hainsworth, John D. / Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer : A phase II trial. In: Journal of Clinical Oncology. 1990 ; Vol. 8, No. 10. pp. 1613-1617.
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title = "Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer: A phase II trial",
abstract = "Twenty-two patients with recurrent small-cell lung cancer (SCLC) were treated with single-agent etoposide 50 mg/m2/d by mouth for 21 consecutive days. Eleven patients had received previous chemotherapy with cyclophosphamide, doxorubicin, and vincristine (CAV) or etoposide (CAE) or both (CAVE). Four of the latter patients also received salvage treatment with cisplatin and etoposide (EP). Nine patients had been treated with EP as induction therapy, while two patients had received high-dose cyclophosphamide, etoposide and cisplatin (HDCEP). Altogether, 18 patients had received previous intravenous etoposide. The median time off chemotherapy was 4.5 months (range, 1 to 28.9 months). Ten patients (45.5{\%}; 95{\%} confidence interval [Cl], 27{\%} to 65{\%}) achieved a complete or partial response. Responses were most common in patients who had responded to previous chemotherapy and who had not received any treatment in the 90 days before initiation of oral etoposide. Median response duration was 4 months (range, 1.5 to 9.5 months) and median survival was 3.5 + months (range, 1.0 to 15+ months). Leukocyte and platelet nadirs were 1,800/μL and 160,000/μL, respectively, during cycle 1 of treatment and occurred between days 21 and 28. Overall, total leukocyte count decreased to less than 1,000/μL during 10 of 56 cycles (18{\%}). Five patients required six hospitalizations for neutropenia and fever. There were two toxic deaths due to sepsis. Platelet counts less than 50,000/μL occurred in 14 cycles (25{\%}). Alopecia developed in all patients; gastrointestinal toxicity was uncommon. This schedule of etoposide administration warrants further study in combination with other active agents in previously untreated patients with SCLC. J Clin Oncol 8:1613-1617.",
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