A PHASE-II STUDY OF CARBOPLATIN AND PROLONGED ADMINISTRATION OF ORAL ETOPOSIDE IN PATIENTS WITH SMALL-CELL LUNG-CANCER

Prolonged oral administration of etoposide may have a theoretical adva ntage over intravenous infusion, and carboplatin has a more favorable toxicity profile than cisplatin. A combination of carboplatin 300 mg/m (2) and oral etoposide 40 mg/m(2)/day for 21 days was assessed in 74 ( 42 limited, 32 extensive disease) previously untreated patients with s mall-cell lung cancer. Response rate was 69% (CR 19%, PR 50%) for limi ted disease and 72% (CR 9%, PR 63%) for extensive disease. Median resp onse duration and overall survival was 6.6 and 10.1 months for limited disease, and 5.3 and 9.1 months for extensive disease, respectively. One-year and two-year survival was 36 and 10% for limited disease and 31 and 2% for extensive disease, respectively. The major toxicity was hematological with grade 4 or greater neutropenia in 36% and grade 4 t hrombocytopenia in 16%, and one patient died of neutropenic fever. Non -hematologic toxicities were mild and grade 3 emesis was observed in 5 % of patients. Carboplatin combined with 21-day oral etoposide showed only modest activity against small-cell lung cancer with high toxicity and did not merit further evaluation.