Randomized comparison of etoposide-cisplatin vs. etoposide-carboplatin and irradiation in small-cell lung cancer

Skarlos, D. V.; Samantas, E.; Kosmidis, P.; Fountzilas, George; Angelidou, Maria; Palamidas, Ph.; Mylonakis, N.; Provata, A.; Papadakis, E.; Klouvas, George

doi:10.1093/oxfordjournals.annonc.a058931

Cited by 240 publications

(94 citation statements)

References 24 publications

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“…27,28 The efficacy of carboplatin and etoposide combination therapy for untreated SCLC is indistinguishable from that of cisplatin and etoposide, with equivalent response rates and survival duration in randomized comparisons. 29,30 Oblimersen dose levels evaluated in the phase I study included 5 and 7 mg/kg/d. 25 This study defined a recommended phase II dose for the three-drug combination of oblimersen 7 mg/kg/d on days 1 through 8, carboplatin area under the concentration curve (AUC) 5 on day 6, and etoposide 80 mg/m 2 /d on days 6 through 8, on a 21-day cycle.…”

Section: Introductionmentioning

confidence: 99%

Randomized Phase II Study of Carboplatin and Etoposide With or Without thebcl-2Antisense Oligonucleotide Oblimersen for Extensive-Stage Small-Cell Lung Cancer: CALGB 30103

Rudin

Salgia

Wang

et al. 2008

JCO

148

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Purpose-To assess the efficacy and toxicity of carboplatin, etoposide, and the bcl-2 antisense oligonucleotide oblimersen as initial therapy for extensive-stage small-cell lung cancer (ES-SCLC). bcl-2 has been implicated as a key factor in SCLC oncogenesis and chemotherapeutic resistance.Patients and Methods-A 3:1 randomized phase II study was performed to evaluate carboplatin and etoposide with (arm A) or without oblimersen (arm B) in 56 assessable patients with chemotherapy-naïve ES-SCLC. Outcome measures including toxicity, objective response rate, complete response rate, failure-free survival, overall survival, and 1-year survival rate.Results-Oblimersen was associated with slightly more grade 3 to 4 hematologic toxicity (88% v 60%; P = .05). Response rates were 61% (95% CI, 45% to 76%) for arm A and 60% (95% CI, 32% to 84%) for arm B. The percentage of patients alive at 1 year was 24% (95% CI, 12% to 40%) with oblimersen, and 47% (95% CI, 21% to 73%) without oblimersen. Hazard ratios for failure-free survival (1.79; P = .07) and overall survival (2.13; P = .02) suggested worse outcome

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Section: Introductionmentioning

confidence: 99%

Randomized Phase II Study of Carboplatin and Etoposide With or Without thebcl-2Antisense Oligonucleotide Oblimersen for Extensive-Stage Small-Cell Lung Cancer: CALGB 30103

Rudin

Salgia

Wang

et al. 2008

JCO

148

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“…Carboplatin is considered to be nearly equivalent to cisplatin in efficacy in SCLC while offering the advantage of outpatient administration (Green and Seal, 1990;Skarlos et al, 1994). Like paclitaxel, carboplatin has radiosensitising properties, which makes the combination of the two drugs with radiotherapy interesting .…”

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confidence: 99%

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Baas

Belderbos

Senan³

et al. 2006

Br J Cancer

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To improve the prognosis of limited stage small cell lung cancer (LS-SCLC) the addition of concurrent thoracic radiotherapy to a platinum-containing regimen is important. In the Netherlands, we initiated a multicenter, phase II study, of the combination of four cycles of carboplatin (AUC 5), paclitaxel (200 mg m À2) and etoposide (2 Â 50 mg orally for 5 days) combined with 45 Gy (daily fractions of 1.8 Gy). The radiation was given to the involved field and concurrently with the second and third chemotherapy cycle. Patients with a partial or complete response received prophylactic cranial irradiation to a dose of 30 Gy. From January 1999 to December 2001, 37 of the 38 patients with LS-SCLC entered were eligible for toxicity analysis and response. Grade 3 and 4 haematological toxicity occurred in 57% (21/37) with febrile neutropenia in 24% (9/37). There were no treatment-related deaths or other grade 4 toxicity. Grade 3 toxicities were oesophagitis (27%), radiation pneumonitis (6%), anorexia (14%), nausea (16%), dyspnea (19%) and lethargy (22%). The objective response rate was 92% (95% confidence interval (CI) 80 -98%) with a median survival time of 19.5 months (95% CI 12.8 -29.2). The 1-, 2-and 5-year survival rate was 70, 47 and 27%, respectively. In field local recurrences occurred in six patients. Distant metastases were observed in 19 patients of which 13 in the brain. This study indicates that combination chemotherapy with concurrent involved-field radiation therapy is an effective treatment for LS-SCLC. Despite PCI, the brain remained the most important site of recurrence.

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“…Comparing cisplatin-etoposide and carboplatin-etoposide in a randomized Phase III trial showed an equal response rate and survival although toxicity was different in both schedules, but acceptable. Myelotoxicity was higher with carboplatinetoposide whereas nephrotoxicity was higher with cisplatinetoposide (20). The comparison of etoposide-cisplatin with etoposide-cisplatin plus ifosfamide in a randomized study showed a statistically significant difference in TTP and median survival (p=0.039 and 0.044, respectively).…”

Section: Discussionmentioning

confidence: 95%

Comparison of cisplatin-paclitaxel combination versus cisplatin-etoposide in patients with small-cell lung cancer: A Phase III study

Stathopoulos¹

1994

Oncol Rep

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Randomized comparison of etoposide-cisplatin vs. etoposide-carboplatin and irradiation in small-cell lung cancer

Abstract: Both treatments proved to be effective, with no differences in response and survival between the two treatment arms. The EC regimen was associated with significantly less toxicity.

Cited by 240 publications

References 24 publications

Randomized Phase II Study of Carboplatin and Etoposide With or Without thebcl-2Antisense Oligonucleotide Oblimersen for Extensive-Stage Small-Cell Lung Cancer: CALGB 30103

Randomized Phase II Study of Carboplatin and Etoposide With or Without thebcl-2Antisense Oligonucleotide Oblimersen for Extensive-Stage Small-Cell Lung Cancer: CALGB 30103

Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

Comparison of cisplatin-paclitaxel combination versus cisplatin-etoposide in patients with small-cell lung cancer: A Phase III study

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