Irinotecan in cancers of the lung and cervix

Irinotecan is active as a single agent in advanced nonsmall cell lung cance r (NSCLC), with overall response rates (ORRs) of 13-32% reported in phase I I trials. In the first-line treatment of stage III/IV NSCLC, phase II studi es have suggested that the combination of irinotecan with cisplatin can ach ieve response rates of 29-75%, which is greater than achieved with older pl atinum-containing combinations. Neutropenia and diarrhea are the dose-limit ing toxicities. In small cell lung cancer (SCLC), irinotecan alone has achi eved ORRs of 16-47% in previously treated SCLC, which is higher than expect ed with oral etoposide. Studies with irinotecan in combination with cisplat in or etoposide have reported responses of up to 79%. Irinotecan is active in cervical cancer patients whose metastases are outside the area of previo us irradiation (ORR 24%) and a major phase II/III study is currently compar ing irinotecan as single agent or in combination with cisplatin against a r eference cisplatin arm. [(C) 1999 Lippincott Williams & Wilkins.].