1
Abstracts were no treatment related deaths in either group. We conclude that when this type of combination chemotherapy is given for non-small-cell carcinoma of the lung, administration of G-CSF can be postponed without clinical problems until the leukocyte count is less than of equal to 1000/mm3. Phase II study of docetaxel (tax&we) in patients with previously un- treated extensive small cell lung cancer. A trial of the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) Latreille J, Corm& V. Martins H. Goss G. Fisher B. Eisenhauer EA. Hotel-Dim de Montreal. 3840 Saint-Urhain. Montreal, Que. HZW ITBInvest New Drugs 1995;13:34335. The objective of this multicenter phase II study was to evaluate the activity of docetaxel in previously untreated small cell lung cancer Fourteen patients were treated at a dose of 75 mg/m’ intravenously every three weeks. Of the I2 patients evaluable for response. one had a partial response for a duration of 12 weeks for a response rate of 8.3%. Toxicity was mild. We conclude that do&axe1 has. at the dose given in this study. little activity in previously untreated small cell lung cancer Phase I trial of intravenous carboplatin added to oral etoposide and oral cyclophosphamide for stage IV non-small cell lung cancer Orunberg SM. Valentine J, Zackon 1, Unger P. Division of Henlatolog~ Oncology, Fletchrr Alien He&h Cure. 111 Colchester Acmue-Putrick 524, Burlmgton. VT 05401. Invest New Drugs 1995;13:33335. The combination of oral etoposide and oral cyclophosphamide is an active and easily administered outpatient regimen for non-small cell lung cancer with leukopenia as the most common severe toxicity. To maintain ease of outpatient administration and to take advantage of a differing dose-hmiting toxicity, we attempted to add escalating doses of intravenous cdrboplatin to full-dose oral etoposide and oral cyclophos- phamide for chemotherapy-naive patients with Stage IV non-small cell lung cancer. The first 4 patients received etoposide and cyclophos- phamide (each at 50 mg p.o. b.i.d., days l-12 every 28 days) with intravenous carboplatin on Day 1 at a dose calculated by the Calvert fortnula to achieve AUC 4. With this regimen dose-limiting toxicity (2 patients with Grade 4 leukopenia/granulocytopenia) was noted. An additional 3 patients therefore received etoposide and cyclophos- phamide at a 25% reduced dose (each at 50 mg PO BID Days l-9 every 28 days) with intravenous carboplatin on Day 1 at a dose calculated to achieve AUC 4. Dose-limiting toxicity (2 patients with Grade 4 leukopenia/granulocytopenia) was again noted. One patient achieved a partial response maintained for 6 months. However potenti- ation of leukopeniaigranulocytopenia by cdrboplatin prevents full-dose use of either cyclophosphamide and etoposide or of carboplatin in this regimen. Is the MVP regimen less active than previously described? Results of a phase II study in advanced non-small cell lung cancer Ferrigno D. Buccheri G. Department of Respirutor). Medicine, A. Cur/e Horpitul, 1-12100 Cunro. Acta Oncol 1996:35:435-9. Combination chemotherapy with anti-proliferative agents is often used in patients with advanced non-small cell lung cancer (NSCLC) in good performance status. The mitomycin C, vinbldstine and cisplatin (MW)) regimen has been the Eastern Cooperative Oncology Group (ECOG) standard for several years because of high response rates in spite of significant toxicity. In a phase II study, we observed 55 consecutive patients treated with MVP chemotherapy using the same dosage, schedule, and precautions as used by the ECOG group. The dose intensity reached for each drug was 85% of the projected dose. Fifty-one patients were assessable for response and toxicity, while all subjects were evaluable for survival. There was no complete remissions, 8 partial (15%), 34 stable (66%) and 9 progressive (17%) in patients. The median survival rate was 34 weeks (95% confidence interval 28-37 weeks). There were no treatment-related deaths and no grade 4 toxicity. Alopecia and emesis were the most significant adverse effects. Haema- tological toxicity was minimal. Other side-effects. such as neuropathy and nephrotoxicity, were also rare. Hence. response rates and toxic complications were lower than previously reported. We conclude that the MVP regimen has to be re-evaluated. Full chemotherapy in elderly patients with small cell bronchial carcinoma Nou E. Department of Lung Medicim. Uppsala Unicrrsity. Akademisku Sjukhuset, S-75185 Uppsala. Acta Oncol 1996:35:399-406. Data on small cell lung cancer (SCLC) in elderly patients with full chemotherapy are sparse. We present material of 345 patients treated with chemotherapy (CT) with no age limits. CT was given with 2 different types of 4-drug combinations, including cyclophosphamide. doxorubtcin, vincristine. methotrexate, lomustine and etoposide. Radio- therapy 40 Gy was given to 85% of the limited disease WD) and 15% of the extensive disease (ED) patients. In 345 consecutive SCLC patients (50% LD and 50%) ED) with a median survival time (MST) of 10 months and a disease-free 5-year survival 3.8%. Multivariate analysis showed clear correlation between stage of disease and survival as well as between age and survival though less pronounced. One hundred and ten patients were > 70 years of age with a median survival time of 7.4 months (LD 12.3 and ED 4.6) and 235 patients < 70 years of age had a median survival time of 10.9 months (LD 14.4 and ED 7.5) and a disease-free 5-year survival of 5.1%. The survival differences were statistically significant. Treatment toxicity was higher in patients z 70 years of age. Seventy-seven patients 70-75 years of age had an MST of 9.5 months (LD 13.2 and ED 6.2) and a disease-free 5-year survival of 1.3%. The survival differences between patients 70-75 years old and those < 70 years of age were small but statistically significant in LD at 5% level but not in ED. There were more septicemias per courses CT given in all patients 70-75 years of age and also more lethal septicemias in ED patients. Patients with LD SCLC 70-75 years of age might benefit from full treatment in terms of median and long-term survival. Analysis of thrombocytopenia due to carboplatin combined with etoposide in elderly patients with lung cancer Shibata K, Nakatsumi V. Kasahara K, Bando T, Fujimurd M, Mat- suds T. Department Internal Medicine (III). Kunaxzwo Unirersit,v. School of Medicine. 13-J Takuramachi. Ix’muzawa 920. J Cancer Res Clin Oncol 1996:122:437-42. Thrombocytopenia induced by cdrboplatin combined with etoposide for elderly lung cancer patients was analyzed in relation to the predicted thrombocytopenia by the equations advocated by Egorin et al. and Tagnchi et al. The thrombocytopenia actually observed was strongly correlated with and significantly more severe than that predicted if carboplatin had been administered as a single agent. The AUC (area under the curve) of carboplatin predicted by Calvert’s equation signili- cantly affected the degree of thrombocytopenia. These data suggested that dosing of carboplatin should be determined individually on the basis of renal function, as recommended earlier. The reason for the enhancement of thrombocytopenia is yet to be determined in future trials. Determinants of myelosuppreszdon in the treatment of non-small cell lung cancer with cisplatin-containing chemotherapy Matsui K, Masuda N. Uchida Yet al. 2nd Department of’ Internul Medicine. Osaka Prrj>ctural Huhikino Hospital. 3-7-l Hahikino. Huhikino. Osaka 583. Jpn J Cancer Res 1996;87:781-6.

Analysis of thrombocytopenia due to carboplatin combined with etoposide in elderly patients with lung cancer

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Page 1: Analysis of thrombocytopenia due to carboplatin combined with etoposide in elderly patients with lung cancer

Abstracts

were no treatment related deaths in either group. We conclude that when this type of combination chemotherapy is given for non-small-cell

carcinoma of the lung, administration of G-CSF can be postponed without clinical problems until the leukocyte count is less than of equal to 1000/mm3.

Phase II study of docetaxel (tax&we) in patients with previously un- treated extensive small cell lung cancer. A trial of the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) Latreille J, Corm& V. Martins H. Goss G. Fisher B. Eisenhauer EA. Hotel-Dim de Montreal. 3840 Saint-Urhain. Montreal, Que. HZW ITBInvest New Drugs 1995;13:34335.

The objective of this multicenter phase II study was to evaluate the activity of docetaxel in previously untreated small cell lung cancer Fourteen patients were treated at a dose of 75 mg/m’ intravenously every three weeks. Of the I2 patients evaluable for response. one had a partial response for a duration of 12 weeks for a response rate of 8.3%. Toxicity was mild. We conclude that do&axe1 has. at the dose given in this study. little activity in previously untreated small cell lung cancer

Phase I trial of intravenous carboplatin added to oral etoposide and oral cyclophosphamide for stage IV non-small cell lung cancer Orunberg SM. Valentine J, Zackon 1, Unger P. Division of Henlatolog~ Oncology, Fletchrr Alien He&h Cure. 111 Colchester Acmue-Putrick 524, Burlmgton. VT 05401. Invest New Drugs 1995;13:33335.

The combination of oral etoposide and oral cyclophosphamide is an active and easily administered outpatient regimen for non-small cell lung cancer with leukopenia as the most common severe toxicity. To maintain ease of outpatient administration and to take advantage of a differing dose-hmiting toxicity, we attempted to add escalating doses of intravenous cdrboplatin to full-dose oral etoposide and oral cyclophos- phamide for chemotherapy-naive patients with Stage IV non-small cell lung cancer. The first 4 patients received etoposide and cyclophos- phamide (each at 50 mg p.o. b.i.d., days l-12 every 28 days) with intravenous carboplatin on Day 1 at a dose calculated by the Calvert fortnula to achieve AUC 4. With this regimen dose-limiting toxicity (2 patients with Grade 4 leukopenia/granulocytopenia) was noted. An additional 3 patients therefore received etoposide and cyclophos- phamide at a 25% reduced dose (each at 50 mg PO BID Days l-9 every 28 days) with intravenous carboplatin on Day 1 at a dose calculated to achieve AUC 4. Dose-limiting toxicity (2 patients with Grade 4 leukopenia/granulocytopenia) was again noted. One patient achieved a partial response maintained for 6 months. However potenti- ation of leukopeniaigranulocytopenia by cdrboplatin prevents full-dose use of either cyclophosphamide and etoposide or of carboplatin in this regimen.

Is the MVP regimen less active than previously described? Results of a phase II study in advanced non-small cell lung cancer Ferrigno D. Buccheri G. Department of Respirutor). Medicine, A. Cur/e Horpitul, 1-12100 Cunro. Acta Oncol 1996:35:435-9.

Combination chemotherapy with anti-proliferative agents is often used in patients with advanced non-small cell lung cancer (NSCLC) in good performance status. The mitomycin C, vinbldstine and cisplatin (MW)) regimen has been the Eastern Cooperative Oncology Group

(ECOG) standard for several years because of high response rates in spite of significant toxicity. In a phase II study, we observed 55 consecutive patients treated with MVP chemotherapy using the same dosage, schedule, and precautions as used by the ECOG group. The dose intensity reached for each drug was 85% of the projected dose. Fifty-one patients were assessable for response and toxicity, while all

subjects were evaluable for survival. There was no complete remissions, 8 partial (15%), 34 stable (66%) and 9 progressive (17%) in patients. The median survival rate was 34 weeks (95% confidence interval 28-37 weeks). There were no treatment-related deaths and no grade 4 toxicity. Alopecia and emesis were the most significant adverse effects. Haema- tological toxicity was minimal. Other side-effects. such as neuropathy and nephrotoxicity, were also rare. Hence. response rates and toxic complications were lower than previously reported. We conclude that the MVP regimen has to be re-evaluated.

Full chemotherapy in elderly patients with small cell bronchial carcinoma Nou E. Department of Lung Medicim. Uppsala Unicrrsity. Akademisku Sjukhuset, S-75185 Uppsala. Acta Oncol 1996:35:399-406.

Data on small cell lung cancer (SCLC) in elderly patients with full chemotherapy are sparse. We present material of 345 patients treated with chemotherapy (CT) with no age limits. CT was given with 2 different types of 4-drug combinations, including cyclophosphamide. doxorubtcin, vincristine. methotrexate, lomustine and etoposide. Radio- therapy 40 Gy was given to 85% of the limited disease WD) and 15% of the extensive disease (ED) patients. In 345 consecutive SCLC patients (50% LD and 50%) ED) with a median survival time (MST) of 10 months and a disease-free 5-year survival 3.8%. Multivariate analysis showed clear correlation between stage of disease and survival as well as between age and survival though less pronounced. One hundred and ten patients were > 70 years of age with a median survival time of 7.4 months (LD 12.3 and ED 4.6) and 235 patients < 70 years of age had a median survival time of 10.9 months (LD 14.4 and ED 7.5) and a disease-free 5-year survival of 5.1%. The survival differences were statistically significant. Treatment toxicity was higher in patients z 70 years of age. Seventy-seven patients 70-75 years of age had an MST of 9.5 months (LD 13.2 and ED 6.2) and a disease-free 5-year survival of 1.3%. The survival differences between patients 70-75 years old and those < 70 years of age were small but statistically significant in LD at 5% level but not in ED. There were more septicemias per courses CT given in all patients 70-75 years of age and also more lethal septicemias in ED patients. Patients with LD SCLC 70-75 years of age might benefit from full treatment in terms of median and long-term survival.

Analysis of thrombocytopenia due to carboplatin combined with etoposide in elderly patients with lung cancer Shibata K, Nakatsumi V. Kasahara K, Bando T, Fujimurd M, Mat- suds T. Department Internal Medicine (III). Kunaxzwo Unirersit,v. School of Medicine. 13-J Takuramachi. Ix’muzawa 920. J Cancer Res Clin Oncol 1996:122:437-42.

Thrombocytopenia induced by cdrboplatin combined with etoposide for elderly lung cancer patients was analyzed in relation to the predicted thrombocytopenia by the equations advocated by Egorin et al. and Tagnchi et al. The thrombocytopenia actually observed was strongly correlated with and significantly more severe than that predicted if carboplatin had been administered as a single agent. The AUC (area under the curve) of carboplatin predicted by Calvert’s equation signili- cantly affected the degree of thrombocytopenia. These data suggested that dosing of carboplatin should be determined individually on the basis of renal function, as recommended earlier. The reason for the enhancement of thrombocytopenia is yet to be determined in future trials.

Determinants of myelosuppreszdon in the treatment of non-small cell lung cancer with cisplatin-containing chemotherapy Matsui K, Masuda N. Uchida Yet al. 2nd Department of’ Internul Medicine. Osaka Prrj>ctural Huhikino Hospital. 3-7-l Hahikino. Huhikino. Osaka 583. Jpn J Cancer Res 1996;87:781-6.