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The chemotherapy combination consisting of etoposide, cisplatin, doxorubicin and cyclophosphamide may improve survival time for patients with extensive small cell lung cancer, according to a recent study published in the

Journal of the National Cancer Institute.

Small cell lung cancer (SCLC) accounts for approximately one-quarter of all lung cancers. This cancer differs from other types of lung cancer in that it tends to spread throughout the body very quickly through the blood and lymph vessels. Extensive SCLC refers to cancer that has spread from its site of origin to distant sites in the body. The standard therapy for patients with this disease is considered to be the combination of etoposide and cisplatin (EP). However, the prognosis for these patients following standard therapy is poor, which has prompted the initiation of many clinical studies evaluating different chemotherapy combinations in order to determine superior regimens.

Researchers from France recently conducted a clinical trial evaluating the efficacy of a novel chemotherapy combination consisting of EP plus doxorubicin and cyclophosphamide (PCDE) in patients with extensive SCLC. The reason for combining additional chemotherapeutic agents is to exploit the differences in the mechanisms through which cancer cells are killed. Patients in this study received either EP or PCDE and were then directly compared. One year following treatment, 40% of patients who received PCDE were still alive compared to only 29% of patients who received EP. The disease progressed more slowly in patients who received PCDE. Treatment related deaths were 9% for patients who received PCDE and 5.5% for patients who received EP.

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These results suggest a significant improvement in one-year survival time for patients with extensive SCLC receiving PCDE compared to the standard regimen of EP. Patients with extensive SCLC may wish to speak with their physician about the risks and benefits of treatment with PCDE or the participation in a clinical trial evaluating novel therapeutic approaches. Two sources of information about ongoing clinical trials include comprehensive, easy-to-use listing services provided by the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients. (

Journal of National Cancer Institute, Vol 93, No 4, pp 300-308, 2001)

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