A randomized trial to evaluate the effect of schedule on the activity of etoposide in small-cell lung cancer.

摘要: Etoposide is an increasingly used and well-tolerated drug in cancer medicine. Its cytotoxic action phase-specific it has demonstrated schedule dependency both vitro animal studies, but clinical evidence of the importance scheduling uncertain. The two administration schedules etoposide that have been compared this randomized study 39 patients with previously untreated extensive small-cell lung treated single-agent were 500 mg/m2 as a continuous intravenous (IV) infusion over 24 hours or five consecutive daily 2-hour infusions each 100 mg/m2. Both regimens repeated every 3 weeks, for maximum six cycles. Patients received combination chemotherapy vincristine, doxorubicin, cyclophosphamide (VAC) radiotherapy on failure to respond at relapse, depending their Karnofsky performance status. same therapy was arms study. All are evaluable response etoposide. In 24-hour arm, achieved partial remission, resulting overall rate 10%. 5-day schedule, 16 had one complete producing 89%, which significantly superior arm (P less than .001). median duration remission 4.5 months. Bone marrow toxicity similar schedules. pharmacokinetics measured all patients, total areas under concentration versus time curves (AUCs) equivalent regimens. This clearly humans, superiority infusion. using efficacious determined be excess 80%.