PROLONGED INFUSION OF ETOPOSIDE IN PATIENTS WITH ADVANCED NONSMALL CELL LUNG-CANCER

We assessed the efficacy and toxicity of two etoposide infusional sche dules in patients with advanced non-small cell lung cancer(NSCLC). Twe nty-six patients were treated with a 21-day infusion every 28 days at a dose of 25-40 mg/m(2)/d, and six patients with a 7-day infusion ever y 21 days at a dose of 45-75 mg/m(2)/d. Sixty-three percent of patient s had a Karnofsky status of 80% or better, and only five (15%) patient s had prior chemotherapy. Plasma etoposide concentrations were determi ned in 26 patients. Sixty-nine treatment cycles were administered. Two patients (6.3%; 90% confidence interval, 1.1-18.4%) had partial respo nses; with response durations of 2 and 7 months, respectively. The med ian survival was 4 months. Grade 3 or 4 neutropenia occurred in 13 of 69 cycles (19%) and was associated with three toxic deaths. Ten patien ts required RBC transfusions. Nausea was common, but was associated wi th vomiting in only 7% of all cycles. The interpatient variability of etoposide concentrations at steady state was significant. We conclude that the antitumor activity of prolonged infusion of etoposide is not superior to standard dose and schedule in advanced NSCLC.