Intensive chemotherapy with recombinant-human granulocyte-macrophage colony stimulating factor (r-hu-gm-csf) for small cell lung cancer (sclc): a pilot study

Abstract

Systemic chemotherapy is the treatment of choice for patients with small cell lung cancer (sclc), Myelosuppression is the limiting toxicity related to most comnbination regimens in sclc, inducing substantial morbidity, frequent dose reductions, and delay in administrating subsequent cycles. Vp-16, Ifosfamide and Carboplatin are all highly active as single agents against sclc, with a ramge of objective response between 60 % and 75 %, A combination of these 3 drugs (with concurrent chest radiotherapy) showed impressive activity) > 90 % objective response rate) in a previous report by another group (Smith, 1990), at the cost of a 100 % incidence of grade III-IV neutropenia, with 7 % therapyrelated deaths and dose reductions required for 72 % of patients. The association of recombinant human granolocyte-macrophage colony stimulating factor (r-hu-gm-csf) to a chemotherapy regimen consisting of Carboplatin and Vp-16 could allow higher doses of cytotoxic drugs to be given, possibly resulting in much higher complete response rates, even in extended disease (Morstyn, 1989). Basing on these data, we designed a pilot study on the association of r-hu-gm-csf to intensive chemotherapy.