Prolonged Oral Etoposide in Combination with Intravenous Cisplatin for Advanced Non-small Cell Lung Cancer

Kim, Ki Hyun; Oh, Sung Yong; Jeong, Hun Sik; Lee, Jong Tae; Kim, Won Seng; Kim, Ho Joong; Yoon, Sung Soo; Kang, Won Ki; Lee, Hong Ghi; Lee, Chong Heon; Park, Chan Hyung; Park, Keun Chil

Abstract

PURPOSE: Etoposide is a schedule-dependent agent and has a synergistic activity with cisplatin. We evaluated the response rate and the toxicity of prolonged oral etoposide in combination with intravenous cisplatin for the previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
Between April 1996 and February 1998, 71 patients were enrolled. The median age was 61 years (range, 36~75) and male: female ratio was 54: 17. Fourteen patients had stage IIIB disease and 57 had stage IV. Sixty-two patients had ECOG performance status of 0 or 1, and 9 had 2. Forty-eight patients had adenocarcinoma, 19 had squamous cell carcinoma and 4 had poorly differentiated NSCLC. Treatment consists of daily oral etoposide 50 mg/m in 2 divided doses for 21 days and intravenous cisplatin 60 mg/m on day 1. The treatment was repeated every 28 days.
RESULTS
Sixty-four of 71 patients were evaluable. Complete response and partial response were observed in 1 and 21 patients, respectively. The overall response rate was 34.4% (95% confidence interval 23.9~46.6%) and the median response duration was 30 weeks (range 13-53 weeks). The median survival of 71 patients was 56 weeks (range 3. 96+ weeks). There was a significantly longer survival in responders (p=0.035). Toxicities were evaluated by WHO criteria. Hematologic toxicities of grade 3, 4 were as follows: anemia 12.3%, leukopenia 8.7%, neutropenia 19.2%, thrombocytopenia 1.8%. Non-hematologic toxicities of grade 3, 4 were as follows: nausea and vomiting 5.9%, stomatitis 14.7%, diarrhea 1.5%. Early treatment-related death occurred in 2 patients (2.8%) due to sepsis.
CONCLUSION
Combination chemotherapy with prolonged oral etoposide and intravenous cisplatin is easy to administer and has moderate activity with acceptable toxicities for NSCLC.