Journal of Clinical Oncology, Vol 5, 185-189, Copyright © 1987 by American Society of Clinical Oncology
Carboplatin (Paraplatin; JM8) and etoposide (VP-16) as first-line combination therapy for small-cell lung cancer
IE Smith, BD Evans, ME Gore, MD Vincent, L Repetto, JR Yarnold and HT Ford
Fifty-two previously untreated patients with small-cell lung carcinoma
(SCLC) were treated with a combination of carboplatin 300 mg/m2
intravenously (IV) on day 1 and etoposide 100 mg/m2 IV on days 1 through 3
every 28 days for four courses. Patients with limited disease (LD)
subsequently received thoracic radiotherapy; no prophylactic cranial
radiotherapy was used. Forty-four patients (85%) achieved an objective
response, including 82% (29% complete remissions) of LD patients and 88%
(13% complete remissions) of extensive-disease (ED) patients. Median
response duration for LD patients was 7 months and 5.5 months for ED
patients. Median survival for both LD and ED patients was 9.5 months.
Myelosuppression was the main toxicity, with World Health Organization
(WHO) grade 3/4 leucopenia occurring in 44% of patients. There was one (2%)
treatment-related neutropenic death. Treatment was otherwise well
tolerated, and in particular no renal toxicity, neurotoxicity, or
ototoxicity was seen. This new combination is highly active in terms of
response rate, but response duration and survival is disappointing, and
might be improved by prolonged treatment or by the use of additional drugs
in combination.
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