According to an article published in the Annals of Oncology, the chemotherapy combination consisting of Camptosar® (irinotecan) plus Paraplatin® (carboplatin) appears to improve progression-free survival compared with VePesid® (etoposide) plus carboplatin in the treatment of extensive small-cell lung cancer.

Lung cancer is the leading cause of cancer-related deaths in the U.S. and Europe. There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Each is named for the type of cell within the lung where the cancer originated.

Extensive SCLC refers to more advanced SCLC in which the cancer has spread from its site of origin to distant or several sites in the body.

Standard treatment for SCLC consists of surgery if possible, chemotherapy, and radiation therapy. One commonly used chemotherapy combination consists of etoposide and cisplatin (Platinol®). However, results have recently suggested that irinotecan plus cisplatin may be just as effective as etoposide/cisplatin, with different side effects.

Since the chemotherapy agent carboplatin provides anticancer activity in much the same way as cisplatin, but is associated with fewer side effects, researchers from Germany recently conducted a clinical trial evaluating carboplatin with irinotecan in extensive SCLC.

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This trial included 70 patients with extensive SCLC who were treated with either irinotecan/carboplatin or etoposide/carboplatin. Irinotecan/carboplatin (IP) appeared superior to etoposide/carboplatin (EP):

  • Anticancer responses were achieved in 67% of patients treated with IP compared with only 51% of patients treated with EP.
  • Median progression-free survival was nine months in patients treated with IP compared with six months for those treated with EP.
  • The most common serious side effects were low levels of platelets and immune cells (both more common among patients treated with EP) and diarrhea (more common in patients treated with IP).

The researchers concluded that the treatment combination consisting of irinotecan and carboplatin appears to provide greater progression-free survival with fewer serious side effects than etoposide and carboplatin in the treatment of extensive SCLC. A phase III trial has been planned to further compare these two regimens in the treatment of this disease; differences in overall survival will be evaluated.

Reference: Schmittel A, Fischer von Weikersthal L, Sebastian M, et al. A Randomized Phase II Trial of Irinotecan plus Carboplatin versus Etoposide plus Carboplatin Treatment in Patients with Extended Disease Small-Cell Lung Cancer. Annals of Oncology. 2006; 17: 663-667.

Related News:Chemotherapy Combinations Produce Equivalent Results in Extensive Stage Small Cell Lung Cancer (5/24/05)

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