High dose tamoxifen plus cisplatin and etoposide in the treatment of patients with advanced, inoperable nonsmall cell lung carcinoma

BACKGROUND. Tamoxifen sensitizes cancer cells to chemotherapeutic agents. H igh dose tamoxifen has been tested in the treatment of patients with melano ma and either cancers. The authors conducted a Phase II study of high dose tamoxifen plus cisplatin and etoposide for patients with advanced, inoperab le nonsmall cell lung carcinoma. METHODS. Patients with Stage IIIB, Stage IV, or recurrent disease; good per formance status; measurable lesions; and good organ function were eligible. Tamoxifen 150 mg/m(2)/day, divided into 4 doses, was given for 8 days. Cis platin 60 mg/m(2) was given on Day 4. Etoposide 60 mg/m(2)/day was given on Days 4-8. Patients were allowed to remain in the study until either intole rable toxicity was observed or disease progression occurred. RESULTS, Forty patients were accrued and received a total of 191 cycles of treatment. All patients were evaluable for response and toxicity. One patie nt had a complete remission and 14 had a partial remission (overall respons e rate, 37.5%). The median survival was 47 weeks. One-year survival was 44% . Increased thrombotic episodes were noted; all were clinically manageable. CONCLUSIONS, High dose tamoxifen can be administered safely in combination with cisplatin and etoposide to patients with advanced nonsmall cell lung c arcinoma. Favorable response rates and survival times were obtained. The va lue of high dose tamoxifen in the treatment of patients with nonsmall cell lung carcinoma can be evaluated further in randomized Phase III studies. (C ) 1999 American Cancer Society.