Cisplatin, etoposide, and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma

Bonnie S. Glisson, Jonathan M. Kurie, Roman Perez-Soler, Nikolous J. Fox, William K. Murphy, Frank V. Fossella, Jin S. Lee, Michael B. Ross, David A. Nyberg, Katherine M W Pisters, Dong M. Shin, Waun Ki Hong

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Abstract

Purpose: The combination of cisplatin, etoposide, and paclitaxel was studied in patients with extensive small-cell lung cancer in a phase I component followed by a phase II trial to determine the maximum-tolerated dose (MTD), characterize toxicity, and estimate response and median survival rates. Patients and Methods: Forty, one patients were treated between October 1993 and April 1997. Doses for the initial cohort were cisplatin 75 mg/m2 on day 1, etoposide 80 mg/m2/d on days 1 to 3, and paclitaxel 130 mg/m2 on day 1 over 3 hours. Cycles were repeated every 3 weeks for up to six cycles. The MTD was reached in the first six patients. In these six patients and in the next 35 patients, who were entered onto the phase II trial, response and survival were estimated. Results: At the initial dose level, one of six patients developed febrile neutropenia, and five of six achieved targeted neutropenia (nadir absolute granulocyte count, 100 to 1,000/μL) without any other dose-limiting toxicity, defining this level as the MTD. Grade 4 neutropenia was observed in 88 (47%) of 188 total courses administered at or less than the MTD. Neutropenia was associated with fever in only 17 (9%) of 188 courses, but two patients experienced neutropenic sepsis that was fatal. Nonhematologic toxicity greater than grade 2 was observed in 10 (5%) of 188 total courses, with fatigue, peripheral neuropathy, and nausea/vomiting most common. The overall objective response rate was 90% of 38 assessable patients: six complete responses (16%) and 28 partial responses (74%). Median progression-free and overall survival durations were 31 and 47 weeks, respectively. Conclusion: The combination of cisplatin, etoposide, and paclitaxel produced response and survival rates similar to those of other combinations and was well tolerated.

Original languageEnglish (US)
Pages (from-to)2309-2315
Number of pages7
JournalJournal of Clinical Oncology
Volume17
Issue number8
StatePublished - Aug 1999
Externally publishedYes

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Small Cell Lung Carcinoma
Etoposide
Maximum Tolerated Dose
Neutropenia
Therapeutics
Survival Rate
TP protocol
Febrile Neutropenia
Peripheral Nervous System Diseases
Paclitaxel
Granulocytes
Nausea
Cisplatin
Disease-Free Survival
Vomiting
Fatigue
Sepsis
Fever
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Glisson, B. S., Kurie, J. M., Perez-Soler, R., Fox, N. J., Murphy, W. K., Fossella, F. V., ... Hong, W. K. (1999). Cisplatin, etoposide, and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma. Journal of Clinical Oncology, 17(8), 2309-2315.

Cisplatin, etoposide, and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma. / Glisson, Bonnie S.; Kurie, Jonathan M.; Perez-Soler, Roman; Fox, Nikolous J.; Murphy, William K.; Fossella, Frank V.; Lee, Jin S.; Ross, Michael B.; Nyberg, David A.; Pisters, Katherine M W; Shin, Dong M.; Hong, Waun Ki.

In: Journal of Clinical Oncology, Vol. 17, No. 8, 08.1999, p. 2309-2315.

Research output: Contribution to journalArticle

Glisson, BS, Kurie, JM, Perez-Soler, R, Fox, NJ, Murphy, WK, Fossella, FV, Lee, JS, Ross, MB, Nyberg, DA, Pisters, KMW, Shin, DM & Hong, WK 1999, 'Cisplatin, etoposide, and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma', Journal of Clinical Oncology, vol. 17, no. 8, pp. 2309-2315.
Glisson, Bonnie S. ; Kurie, Jonathan M. ; Perez-Soler, Roman ; Fox, Nikolous J. ; Murphy, William K. ; Fossella, Frank V. ; Lee, Jin S. ; Ross, Michael B. ; Nyberg, David A. ; Pisters, Katherine M W ; Shin, Dong M. ; Hong, Waun Ki. / Cisplatin, etoposide, and paclitaxel in the treatment of patients with extensive small-cell lung carcinoma. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 8. pp. 2309-2315.
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abstract = "Purpose: The combination of cisplatin, etoposide, and paclitaxel was studied in patients with extensive small-cell lung cancer in a phase I component followed by a phase II trial to determine the maximum-tolerated dose (MTD), characterize toxicity, and estimate response and median survival rates. Patients and Methods: Forty, one patients were treated between October 1993 and April 1997. Doses for the initial cohort were cisplatin 75 mg/m2 on day 1, etoposide 80 mg/m2/d on days 1 to 3, and paclitaxel 130 mg/m2 on day 1 over 3 hours. Cycles were repeated every 3 weeks for up to six cycles. The MTD was reached in the first six patients. In these six patients and in the next 35 patients, who were entered onto the phase II trial, response and survival were estimated. Results: At the initial dose level, one of six patients developed febrile neutropenia, and five of six achieved targeted neutropenia (nadir absolute granulocyte count, 100 to 1,000/μL) without any other dose-limiting toxicity, defining this level as the MTD. Grade 4 neutropenia was observed in 88 (47{\%}) of 188 total courses administered at or less than the MTD. Neutropenia was associated with fever in only 17 (9{\%}) of 188 courses, but two patients experienced neutropenic sepsis that was fatal. Nonhematologic toxicity greater than grade 2 was observed in 10 (5{\%}) of 188 total courses, with fatigue, peripheral neuropathy, and nausea/vomiting most common. The overall objective response rate was 90{\%} of 38 assessable patients: six complete responses (16{\%}) and 28 partial responses (74{\%}). Median progression-free and overall survival durations were 31 and 47 weeks, respectively. Conclusion: The combination of cisplatin, etoposide, and paclitaxel produced response and survival rates similar to those of other combinations and was well tolerated.",
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AU - Glisson, Bonnie S.

AU - Kurie, Jonathan M.

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AU - Fox, Nikolous J.

AU - Murphy, William K.

AU - Fossella, Frank V.

AU - Lee, Jin S.

AU - Ross, Michael B.

AU - Nyberg, David A.

AU - Pisters, Katherine M W

AU - Shin, Dong M.

AU - Hong, Waun Ki

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N2 - Purpose: The combination of cisplatin, etoposide, and paclitaxel was studied in patients with extensive small-cell lung cancer in a phase I component followed by a phase II trial to determine the maximum-tolerated dose (MTD), characterize toxicity, and estimate response and median survival rates. Patients and Methods: Forty, one patients were treated between October 1993 and April 1997. Doses for the initial cohort were cisplatin 75 mg/m2 on day 1, etoposide 80 mg/m2/d on days 1 to 3, and paclitaxel 130 mg/m2 on day 1 over 3 hours. Cycles were repeated every 3 weeks for up to six cycles. The MTD was reached in the first six patients. In these six patients and in the next 35 patients, who were entered onto the phase II trial, response and survival were estimated. Results: At the initial dose level, one of six patients developed febrile neutropenia, and five of six achieved targeted neutropenia (nadir absolute granulocyte count, 100 to 1,000/μL) without any other dose-limiting toxicity, defining this level as the MTD. Grade 4 neutropenia was observed in 88 (47%) of 188 total courses administered at or less than the MTD. Neutropenia was associated with fever in only 17 (9%) of 188 courses, but two patients experienced neutropenic sepsis that was fatal. Nonhematologic toxicity greater than grade 2 was observed in 10 (5%) of 188 total courses, with fatigue, peripheral neuropathy, and nausea/vomiting most common. The overall objective response rate was 90% of 38 assessable patients: six complete responses (16%) and 28 partial responses (74%). Median progression-free and overall survival durations were 31 and 47 weeks, respectively. Conclusion: The combination of cisplatin, etoposide, and paclitaxel produced response and survival rates similar to those of other combinations and was well tolerated.

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