Cisplatin plus oral etoposide in the treatment of patients with advanced small cell lung cancer

Background: Etoposide is a highly schedule-dependent drug. We investigated combination chemotherapy of oral etoposide and intravenous cisplatin for sm all cell lung cancer (SCLC). Methods: Fifty-seven patients with SCLC with extensive disease (ED) or limi ted disease (LD) with pleural effusion registered in the 21 institutions of the Japan Clinical Oncology Group were treated with oval etoposide 40 mg/m (2)/d for 21 days and cisplatin 80 mg/m(2) on day 1 of every 28-period day. The entry period was between February 1992 and August 1995. The actual per centages of patients treated with etoposide were 93.6, 89.5, 92.3 and 96.9% in the first, second, third and fourth cycles, respectively. Results: Nine patients(15.8%) achieved a complete response resulting in an overall response rate of 82.5% (95% confidence interval, 70.1-91.3%). Leuko penia and thrombocytopenia of grade 3 or 4 were observed in 36 (49.1%) and 8 (14.0%) patients, respectively. Anemia of grade 3 or 4 occurred in 28 (49 .1%) patients. Nausea, vomiting, anorexia and alopecia were common adverse events. One patient died of hemoptysis due to grade 4 thrombocytopenia. The mean survival time was 47.0 weeks. Conclusions: This dose and schedule of administration of etoposide in combi nation with cisplatin are considered to be clinically active. However, prol onged gastrointestinal toxicity of oral etoposide was a problem in comparis on with the standard etoposide platinum regimen given by intravenous admini stration.