According to results recently published in the Journal of Clinical Oncology, the chemotherapy agent Hycamtin® (topotecan) taken orally in the pill form plus the chemotherapy agent cisplatin (Platinol®) produce nearly equivalent outcomes with increased convenience compared to the intravenous form of etoposide (VePesid®) plus cisplatin in extensive small cell lung cancer. These results were also presented at the 2005 annual meeting of the American Society of Clinical Oncology.
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 and non-small cell lung cancer. The distinction in lung cancer types often determines the treatment options since each type responds differently to treatment.
Current treatment options for SCLC include surgery, chemotherapy, and radiation. The chemotherapy regimen considered the standard of care for extensive stage SCLC is the combination of the drugs etoposide and cisplatin. However, this combination has the immediate drawback of being administered intravenously (into a vein). Intravenous administration means that patients must make extended office visits-particularly inconvenient if a patient lives far from a medical facility that administers chemotherapy. Other complications include increased risk of pain and infection and greater expense than drugs given orally.
Researchers from Europe conducted a clinical trial to compare the effectiveness of the oral administration of Hycamtin in addition to cisplatin to the standard intravenous administration of etoposide/cisplastin as initial treatment for 784 patients with extensive-stage SCLC.
- Overall anticancer responses were achieved in 63% of patients treated with oral Hycamtin/cisplatin and in 69% of patients treated with etoposide/cisplatin.
- The average overall survival was almost the same in both groups (39 weeks for oral Hycamtin and 40 weeks for etoposide).
- Survival at one year was 31% for both groups.
- Severe side effects included vomiting and low levels of immune cells for the group treated with etoposide; those treated with oral Hycamtin experienced low levels of platelets and red blood cells as well as diarrhea.
The researchers concluded that the oral form of Hycamtin produces nearly equivalent outcomes as initial therapy for extensive-stage SCLC as standard intravenous administration of etoposide in combination with cisplatin. Oral administration provides considerably more convenience for patients compared to intravenous administration. Patients diagnosed with extensive-stage SCLC may wish to speak with their physician about their individual risks and benefits of participating in a clinical trial further evaluating the oral form of Hycamtin.
 Eckardt J, von Pawel J, Manikhas G et al. Open-Label, Multicenter, Randomized, Phase III Study Comparing Oral Topotecan/Cisplatin Versus Etoposide/Cisplatin As Treatment for Chemotherapy-Naive Patients With Extensive-Disease Small-Cell Lung Cancer. Journal of Clinical Oncology. 2006; 24: 2044-2051.
 Eckardt J, von Pawel J, Manikhas G et al. Comparable activity with oral topotecan/cisplatin (TC) and IV etoposide/cisplatin (PE) as treatment for chemotherapy-naïvepatients (pts) with extensive disease small cell lung cancer (ED-SCLC): Final results of a randomized phase III trial (389). Proceedings of the 2005 meeting of the American Society of Clinical Oncology:abstract 7003.
Related News:Oral Hycamtin® plus Cisplatin Active and Convenient in Advanced Small Cell Lung Cancer (7/5/2005)
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