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A Phase I/II study of docetaxel, etoposide, and carboplatin before concurrent chemoradiotherapy with cisplatin and etoposide in limited-stage small cell lung cancer

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Summary

Limited stage small cell lung cancer (LS-SCLC) is an infrequent but aggressive tumor. No major advances in the treatment of this disease have been achieved in recent years. This study was conducted to determine the maximum-tolerated dose (MTD) and efficacy of docetaxel, etoposide, and carboplatin (DEC) given before definitive chest radiotherapy with concurrent cisplatin and etoposide. Seventeen untreated LS-SCLC patients received docetaxel 50 mg/m2, etoposide 50–80 mg/m2, and carboplatin AUC = 5–6, intravenously on day 1 followed by etoposide 100–160 mg/m2 orally on days 2 and 3 every 21 days for two cycles followed by once daily radiotherapy to a total dose of 50 Gy given concurrently with cisplatin (60 mg/m2, d1) and etoposide (120 mg/m2, d1 and 240 mg/m2 day 2–3) for 2 cycles. All patients were assessable for toxicity and 15 for response. The most frequent toxicity was grade 3 and 4 neutropenia in 41% of patients during DEC and in 57% with chemoradiation. The MTD for DEC was docetaxel 50 mg/m2 plus carboplatin AUC = 5 and etoposide 50/100 mg/m2 with growth factor support. Significant nonhematologic toxicities were primarily radiation-related esophagitis (43%). One patient (6%) died from toxicity. The overall response rate was 82% with 10 patients (59%) achieving a complete response. The median survival was 12.1 months (95% CI, 6.4–17.8 months) and the 1-year survival rate was 47%. This novel approach produced similar efficacy results to current two drug regimens but was associated with significant neutropenia. Alternative strategies to increase complete response rates and survival are needed.

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Authors and Affiliations

  1. Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado, 80010, USA

    Patrapim Sunpaweravong, Lyn Magree, Paul Bunn & Karen Kelly

  2. Prince of Songkla University, Songkla, Thailand, 90110

    Patrapim Sunpaweravong

  3. Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, Colorado, 80010, USA

    Rachel Rabinovitch

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  1. Patrapim Sunpaweravong
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  2. Lyn Magree
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  3. Rachel Rabinovitch
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  4. Paul Bunn
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  5. Karen Kelly
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Correspondence to Karen Kelly.

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Sunpaweravong, P., Magree, L., Rabinovitch, R. et al. A Phase I/II study of docetaxel, etoposide, and carboplatin before concurrent chemoradiotherapy with cisplatin and etoposide in limited-stage small cell lung cancer. Invest New Drugs 24, 213–221 (2006). https://doi.org/10.1007/s10637-005-3669-3

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  • DOI: https://doi.org/10.1007/s10637-005-3669-3

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