P-567 Topotecan/carboplatin 5 days versus topotecan/carboplatin 3 days in patients with metastasic small cell lung cancer

Topotecan in the Treatment of Recurrent Small Cell Lung Cancer: An Update

“…Furthermore, topotecan plus cisplatin may also be an option in the first-line treatment of patients with SCLC [49]. In the first-line setting, for topotecan and cisplatin combination regimens, administration of cisplatin on the final day of topotecan therapy for each cycle, instead of on day 1, appeared to decrease the need for dose reductions to manage neutropenia [50,51], and toxicity may also be sequence dependent in the second-line setting.…”

Topotecan in the First-Line Treatment of Small Cell Lung Cancer

“…However, despite the use of G-CSF support, this regimen was associated with severe neutropenia, and platinum agents were administered later during the treatment cycle in subsequent clinical trials. For example, Seifart et al [28,29] investigated regimens that combined topotecan with either cisplatin or carboplatin, administered on day 5 of the treatment cycle instead of day 1. In the first of these randomized phase II trials [28], cisplatin (75 mg/m 2 ) was administered on day 5 and combined with topotecan, either 1.0 mg/m 2 on days 1-5 or 1.5 mg/m 2 on days 1-3 of a 21-day cycle.…”

“…For example, Seifart et al [28,29] investigated regimens that combined topotecan with either cisplatin or carboplatin, administered on day 5 of the treatment cycle instead of day 1. In the first of these randomized phase II trials [28], cisplatin (75 mg/m 2 ) was administered on day 5 and combined with topotecan, either 1.0 mg/m 2 on days 1-5 or 1.5 mg/m 2 on days 1-3 of a 21-day cycle. Toxicities and efficacies were generally comparable between treatment arms, but a higher proportion of patients on the 5-day topotecan regimen experienced grade 3 or 4 hematologic toxicities compared with the 3-day regimen.…”

“…Moreover, recent evidence from a phase III trial suggests that the combination of another topoisomerase-I inhibitor (irinotecan; Camptosar ® ; Pfizer Pharmaceuticals Inc.; New York, NY) with cisplatin in patients with extensive SCLC has a comparable toxicity profile and produces a significantly longer median survival time than standard PE therapy (12.8 months for irinotecan/cisplatin versus 9.4 months for etoposide/cisplatin; p = 0.002) [19]. In the first-line SCLC setting, topotecan has been investigated in doublet regimens with cisplatin, carboplatin (Paraplatin ® ; Bristol-Myers Squibb), paclitaxel, and etoposide (Table 1) [20][21][22][23][24][25][26][27][28][29].…”

First-line chemotherapy in metastatic small-cell lung cancer (SCLC)

“…over 30 minutes on 5 consecutive days. Due to severe myelotoxicity, G-CSF had to In a German multicentre phase-II trial [50] a total of 86 patients were included. Patients were randomized to receive either topotecan 1.0 mg/m 2 d1-5 and cisplatin 75 mg/m 2 d5 (Arm A) or topotecan 1.5 mg/m 2 d1-3 and cisplatin 75 mg/m 2 d3 (Arm B).…”