New combination of the old drugs for elderly patients with small-cell lung cancer: a phase II study of the PAVE regimen.

Westeel, Virginie; Murray, Nevin; Gelmon, Karen A.; Shah, Amil M.; Sheehan, Finbar; McKenzie, Michael; Wong, Frances; Morris, James; Grafton, C.; Tsang, Victor; Goddard, Karen; Murphy, Kevin; Parsons, Christina; Amy, R.M.; Page, R.

doi:10.1200/jco.1998.16.5.1940

Cited by 59 publications

(20 citation statements)

References 8 publications

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“…However, the more common situation is of elderly patients who have comorbidity and a poor PS, and cannot tolerate a standard single dose of cisplatin. Westeel et al (1998) and Murray et al (1998) reported that split doses of cisplatin were safely and effectively administered in elderly or frail patients with LD-SCLC. The SPE regimen appeared to be an appropriate treatment for elderly patients with SCLC who cannot tolerate a standard single dose of cisplatin.…”

Section: Discussionmentioning

confidence: 99%

“…The Japan Clinical Oncology Group (JCOG) has reported that carboplatin plus etoposide (CE) is an active and less toxic regimen in elderly patients with SCLC (Okamoto et al, 1999). However, other clinical trials have indicated that the combination chemotherapy of reduced (Souhami et al, 1997) or split doses of cisplatin plus etoposide (SPE) Westeel et al, 1998) can be safely and effectively administered in elderly or poor-risk patients with SCLC. Therefore, we conducted a phase III trial comparing CE with SPE in elderly or poor-risk patients with SCLC.…”

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confidence: 99%

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Randomised phase III trial of carboplatin plus etoposide vs split doses of cisplatin plus etoposide in elderly or poor-risk patients with extensive disease small-cell lung cancer: JCOG 9702

et al. 2007

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We compared the efficacy and the safety of a carboplatin plus etoposide regimen (CE) vs split doses of cisplatin plus etoposide (SPE) in elderly or poor-risk patients with extensive disease small-cell lung cancer (ED-SCLC). Eligibility criteria included: untreated ED-SCLC; age X70 and performance status 0 -2, or age o70 and PS 3. The CE arm received carboplatin area under the curve of five intravenously (IV) on day 1 and etoposide 80 mg m À2 IV on days 1 -3. The SPE arm received cisplatin 25 mg m À2 IV on days 1 -3 and etoposide 80 mg m À2 IV on days 1 -3. Both regimens were given with granulocyte colony-stimulating factor support in a 21 -28 day cycle for four courses. A total of 220 patients were randomised. Median age was 74 years and 74% had a PS of 0 or 1. Major grade 3 -4 toxicities were (%CE/%SPE): leucopenia 54/51, neutropenia 95/90, thrombocytopenia 56/16, infection 7/6. There was no significant difference (CE/SPE) in the response rate (73/73%) and overall survival (median 10.6/9.9 mo; P ¼ 0.54). Palliation scores were very similar between the arms. Although the SPE regimen is still considered to be the standard treatment in elderly or poor-risk patients with ED-SCLC, the CE regimen can be an alternative for this population considering the risk -benefit balance.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Randomised phase III trial of carboplatin plus etoposide vs split doses of cisplatin plus etoposide in elderly or poor-risk patients with extensive disease small-cell lung cancer: JCOG 9702

et al. 2007

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“…Main retrospective chart reviews on different therapeutic approaches in elderly SCLC patients aged ≥70 Abbreviations: CAV = cyclophosphamide + adriamycin + vincristine; CT = chemotherapy; ED = extensive disease; LD = limited disease; MST = median survival time; OCA = vincristine + cyclophosphamide + doxorubicin; OR = objective response; PE = cisplatin + etoposide; RT = radiotherapy; SCLC = small cell lung cancer. months, respectively) [90]. Ardizzoni et al [89], in a randomized phase II trial including 95 patients, compared two different doses (full versus low) of cisplatin plus etoposide, with G-CSF support in the full-dose arm.…”

Section: New Regimens Specifically Designed For Elderly Patientsmentioning

confidence: 99%

“…Several authors have performed phase II trials employing third-generation combination chemotherapy and designing specific regimens for the elderly [85][86][87][88][89][90][91][92]. A low-dose combination of cisplatin, doxorubicin, vincristine, and etoposide (the PAVE regimen) resulted in impressive RRs (92% in LD-SCLC and 87% in ED-SCLC, with MSTs of 16.2 and 10.8…”

Section: New Regimens Specifically Designed For Elderly Patientsmentioning

confidence: 99%

Treatment of Small Cell Lung Cancer in the Elderly

et al. 2005

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Small cell lung cancer (SCLC) accounts for approximately 20% of lung carcinomas. Chemotherapy is the cornerstone of treatment for SCLC. In limited disease, the median survival time is about 12-16 months, with a 4%-5% long-term survival rate; in extensive disease the median survival time is 7-11 months. More than 50% of lung cancer patients are diagnosed when they are over the age of 65, and about 30% are over 70. Elderly patients tolerate chemotherapy poorly compared with their younger counterparts, because of agerelated progressive reductions in organ function and comorbidities. The standard therapy for limited disease is combined chemoradiotherapy, followed by prophylactic brain irradiation for patients achieving complete responses. In the elderly, the addition of radiotherapy to chemotherapy must be carefully evaluated, considering the slight survival benefit and potential for substantial toxicity incurred with this treatment. The best approach is to design clinical trials that specifically include geriatric assessment to develop active and well-tolerated chemotherapy regimens for elderly SCLC patients. Survival improvement for SCLC patients requires a better understanding of tumor biology and the subsequent development of novel therapeutic strategies. Several targeted agents have been introduced into clinical trials in SCLC, but a minority of these new agents offers a promise of improved outcomes, and negative results are reported more commonly than positive ones. This review focuses on the main issues in the treatment of elderly SCLC patients. The Oncologist 2005;10:399-411The Oncologist 2005;10:399-411 www.TheOncologist.com

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“…A policy of combination chemotherapy regimes specifically designed for elderly patients has been investigated by the Canadian lung cancer group in Vancouver [68,75]. In the period 1982-1991 elderly or infirm patients with limited SCLC were offered a standard treatment of one-cycle CAV followed 3 weeks later by one-cycle EP plus concurrent thoracic radiotherapy, 20 Gy in 5 fractions or 30 Gy in 10 fractions.…”

Section: Elderly Patientsmentioning

confidence: 99%

Chemotherapy in small cell lung cancer

Østerlind¹

2001

European Respiratory Journal

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New combination of the old drugs for elderly patients with small-cell lung cancer: a phase II study of the PAVE regimen.

Cited by 59 publications

References 8 publications

Randomised phase III trial of carboplatin plus etoposide vs split doses of cisplatin plus etoposide in elderly or poor-risk patients with extensive disease small-cell lung cancer: JCOG 9702

Randomised phase III trial of carboplatin plus etoposide vs split doses of cisplatin plus etoposide in elderly or poor-risk patients with extensive disease small-cell lung cancer: JCOG 9702

Treatment of Small Cell Lung Cancer in the Elderly

Chemotherapy in small cell lung cancer

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