IRINOTECAN IN LYMPHOMA, LEUKEMIA, AND BREAST, PANCREATIC, OVARIAN, AND SMALL-CELL LUNG CANCERS

Irinotecan (CPT-11 [Camptosar]) has a broad range of antitumor activit y. Extensive preclinical and early clinical work has demonstrated its activity against many tumor types-head and neck, esophagus, stomach, p ancreas, liver, colon/rectum, kidney, lymph nodes, ovary, uterine, cer vix, sarcoma, melanoma, acute and chronic leukemia, mesothelioma, and cancers of unknown primary site. Most of the phase II and III trials h ave focused on colorectal and other gastrointestinal, nan-small-cell l ung, and cervical cancers (discussed elsewhere in this monograph). Thi s article presents preliminary results of studies exploring the use of irinotecan in lymphoma, leukemia, and breast, pancreatic, ovarian, an d small-cell lung cancers. In all of these studies, the number of pati ents enrolled is small, drug doses and schedules differ (often within the same case series), and little information is available on response duration and overall survival. Nevertheless, irinotecan has shown rep roducible if at times modest activity in almost all of the diseases in which if has been studied. Future research should be directed at cond ucting well-designed clinical trials of irinotecan alone and in combin ation with other agents.