VP-16-213 in combination chemotherapy with chest irradiation for small-cell lung cancer: a randomized trial of the Piedmont Oncology Association.

Publisher Website
Google Scholar
Abstract
The role of etoposide, epipdophyllotoxin (VP-16-213), in a combined modality treatment program incorporating local chest irradiation and combination chemotherapy with cyclophosphamide, adriamycin and vincristine was evaluated in a randomized trial of 165 patients with small-cell lung cancer. The overall response rate (complete response [CR] plus partial response [PR]) was significantly greater in the VP-16-213 arm (85% vs. 64%, P = 0.005) primarily as a consequence of improved response in patients with extensive disease (85% vs. 38%, P = 0.002 and 30% vs. 8% for CR only, P = 0.045). No differences in the response rates were observed in limited disease. The duration of response (months) was greater in the VP-16-213 arm (8.6 vs. 7.0 overall and 14.4 vs. 11.5 for CR) but not significantly so. Median survival times (months) were consistently greater in the group receiving VP-16-213 when analyzed according to extent of disease and response (10.6 vs. 9.5 overall; 15.0 vs. 13.6 for limited disease; 9.0 vs. 6.7 for extensive disease; 18.5 vs. 16.2 for CR overall; and 18.6 vs. 16.1 for CR in limited disease); the results were not statistically significant. The median survival of extensive disease patients attaining a CR was 15.3 mo. (range 3.2-34.3 + mo.) in the VP-16-213 arm and 7.4 + and 8.1 + mo. for the 2 patients with CR in the other group. Anemia and leukopenia occurred to a greater degree in the 4-drug regimen, but no unusual or significant compounding toxicity (i.e., neurotoxicity) was observed otherwise. Further investigation of this agent in combination chemotherapy programs for small-cell lung cancer appears to be warranted.

This publication has 1 reference indexed in Scilit: