146 High-dose chemotherapy with PBSCT for small cell lung cancer

Lung Cancer ◽  
1997 ◽  
Vol 18 ◽  
pp. 40 ◽  
Author(s):  
C. Kitada ◽  
Y. Yamanaka ◽  
H. Tokumoto ◽  
C. Yoshimura ◽  
H. Kitajima ◽  
...  
Lung Cancer ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 39 ◽  
Author(s):  
U Seifart ◽  
M Schröder ◽  
K Hans ◽  
D Ukena ◽  
K.P Thiele ◽  
...  

2012 ◽  
Vol 6 (1) ◽  
pp. 4 ◽  
Author(s):  
Syed Mustafa Karim ◽  
Jamal Zekri

Combination chemotherapy is the current strategy of choice for treatment of small cell lung cancer (SCLC). Platinum containing combination regimens are superior to non-platinum regimens in limited stage- SCLC and possibly also in extensive stage-SCLC as first and second-line treatments. The addition of ifosfamide to platinum containing regimens may improve the outcome but at the price of increased toxicity. Suboptimal doses of chemotherapy result in inferior survival. Early intensified, accelerated and high-dose chemotherapy gave conflicting results and is not considered a standard option outside of clinical trials. A number of newer agents have provided promising results when used in combination regimens, for example, gemcitabine, irinotecan and topotecan. However, more studies are required to appropriately evaluate them. There is a definitive role for radiotherapy in LD-SCLC. However, timing and schedule are subject to further research. Novel approaches are currently being investigated in the hope of improving outcome.


1999 ◽  
Vol 17 (11) ◽  
pp. 3531-3539 ◽  
Author(s):  
S. Leyvraz ◽  
L. Perey ◽  
G. Rosti ◽  
A. Lange ◽  
S. Pampallona ◽  
...  

PURPOSE: To determine the feasibility and safety of multiple sequential courses of high-dose chemotherapy and peripheral-blood progenitor cells (PBPCs) administered in a multicenter setting to patients with small-cell lung cancer. PATIENTS AND METHODS: Sixty-nine patients (limited disease, n = 30; extensive disease, n = 39) treated at 15 European centers were scheduled to receive three courses of high-dose chemotherapy with ifosfamide 10 g/m2, carboplatin 1200 mg/m2, and etoposide 1200 mg/m2 (ICE) divided over 4 days at 28-day intervals. PBPCs were harvested before treatment and mobilized with epirubicin 150 mg/m2 administered via an intravenous bolus divided over 2 days and filgrastim 5 μg/kg/d administered subcutaneously. RESULTS: The performed leukaphereses (one to five per patient) yielded a median of 16.6 × 106/kg (range, 1.0 to 96.6 × 106/kg) CD34+ cells, which was sufficient for three reinfusions. Fifty patients (72%) completed the treatment according to schedule. Nine patients completed two courses, and six patients completed one course of treatment. The increase in dose-intensity was 290% that of a standard ICE regimen. The median duration of myelosuppression was similar between courses, namely 4 days (range, 1 to 12 days) for leukocytes less than 0.5 × 109/L and 4 days (range, 0 to 22 days) for thrombocytes less than 20 × 109/L. Febrile neutropenia developed in 66% of courses, severe diarrhea in 14%, mucositis in 10%, and nausea and vomiting in 21% of courses. There were six cases of toxic death (9%), most of which occurred in the first year of accrual and thus were attributable to the learning curve. The antitumor effect of the regimen was reflected in an 86% remission rate (95% confidence interval [CI], 74% to 93%), with 51% of patients achieving a complete response (95% CI, 38% to 63%). Median overall survival was 18 months for patients with limited disease and 11 months for patients with extensive disease. CONCLUSION: This multiple sequential high-dose ICE regimen could be safely administered on a multicenter basis to patients with small-cell lung cancer. The dose-intensity could be increased to 290% that of standard ICE regimen. The benefit of this approach is currently being tested in a randomized trial that aims to double the long-term rate of survival for patients with small-cell lung cancer.


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