Abstract
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-limiting toxicity, we attempted to add escalating doses of intravenous carboplatin to full-dose oral etoposide and oral cyclophosphamide for chemotherapy-naive patients with Stage IV non-small cell lung cancer. The first 4 patients received etoposide and cyclophosphamide (each at 50 mg PO BID Days 1–12 every 28 days) with intravenous carboplatin on Day 1 at a dose calculated by the Calvert formula 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 cyclophosphamide at a 25% reduced dose (each at 50 mg PO BID Days 1–9 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 potentiation of leukopenia/granulocytopenia by carboplatin prevents full-dose use of either cyclophosphamide and etoposide or of carboplatin in this regimen.
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Rapp E, Pater JL, Willan A, Cormier Y, Murray N, Evans WK, Hodson DI, Clark DA, Feld R, Arnold AM, Ayoub JI, Wilson KS, Latreille J, Wierzbicki RF, Hill DP: Chemotherapy can prolong survival in patients with advanced non-small cell lung cancer report of a Canadian multicentre randomized trial. J Clin Oncol 6:633–641, 1988
Grunberg SM, Crowley J, Livingston R, Gill I, Williamson SK, O'Rourke T, Braun T, Marshall ME, Weick JK, Balcerzak SP, Martine RL: Extended administration of oral etoposide and oral cyclophosphamide for the treatment of advanced non-small cell lung cancer: a Southwest Oncology Group study. J Clin Oncol 11:1598–1601, 1993
Calvert AH, Newell DR, Gumbrell LA, O'Reilly S, Burnell M, Boxall FE, Siddik ZH, Judson IR, Gore ME, Wiltshaw E: Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7:1748–1756, 1989
Miller AA, Niell HB, Griffin JP: Phase II study of prolonged oral etoposide in combination with intravenous cisplatin in advanced non-small cell lung cancer. Lung Cancer 12:59–65, 1995
Johnson DH, DeVore R, Greco FA, Walls J, Thomas M, Hande KR, Hainsworth JD: Carboplatin plus oral etoposide in the management of advanced, non-small cell lung cancer: preliminary results of a Vanderbilt trial. Semin Oncol 19 (1 suppl 2):50–56, 1992
Shepherd FA, Evans WK, Goss PE, Latreille J, Logan D, Maroun J, Stewart D, Warner E, Paul K: Ifosfamide, cisplatin, and etoposide (ICE) in the treatment of advanced non-small cell lung cancer. Semin Oncol 19 (1 suppl 2):54–58, 1992
Wolff AC, Ettinger DS, Neuberg D, Comis RL, Ruckdeschel JC, Bonomi PD, Johnson DH: Phase II study of ifosfamide, carboplatin, and oral etoposide chemotherapy for extensive-disease small-cell lung cancer: an Eastern Cooperative Oncology Group pilot study. J Clin Oncol 13:1615–1622, 1995
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Grunberg, S.M., Valentine, J., Zackon, I. et al. Phase I trial of intravenous carboplatin added to oral etoposide and oral cyclophosphamide for stage IV non-small cell lung cancer. Invest New Drugs 13, 333–335 (1995). https://doi.org/10.1007/BF00873140
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DOI: https://doi.org/10.1007/BF00873140