Efficacy of CPT-11, paclitaxel and carboplatin combination in advanced non-small cell lung cancer (NSCLC)
Aggarwal, Shyam; Chadha, S.K.; Kulpati, D.D.S.; Jain, N.; Agarwal, S.; Bhalotra, B. and Buxi, T.V.S. (2002) Efficacy of CPT-11, paclitaxel and carboplatin combination in advanced non-small cell lung cancer (NSCLC). Proceedings of the American Society of Oncology. A2766.
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Objective: To study the efficacy of three drug combination in advanced non-small cell lung cancer. Paclitaxel and carboplatin combination is one of the active protocols in the management of advanced NSCLC. CPT-11 has also been found to be effective in several phase I/II studies in NSCLC. CPT-11 and taxanes have demonstrated additive and synergistic activity in pre-clinical models. This forms the basis for the study using three drugs in the management of advanced NSCLC. Method: Nineteen patients have been enrolled so far. There are fourteen males and five females. Median age is 50 years. Eight patients had pleural effusion, two had bone metastases, one had bilateral lung involvement, eleven had hilar lymphadenopathy, two had cervical lymph nodes and two had asymptomatic CNS involvement. Patients had ECOG performance status 0-2 at enrollment. The hematological, renal and hepatic profiles were normal. Patients with symptomatic CNS involvement were excluded. Nine patients had stage IV, ten had stage IIIB. The chemotherapy protocol used was as follows: Paclitaxel 125 mg/m2 dl, CPT-11 -125mg/m2 d2, Carboplatin 300mg/ m2 d2. Three weekly regimen was followed. Results: Three patients were not eligible for evaluation of response. Nine patients (55%) had a partial response, two patients (16%) had stable disease and five patients (39%) had progressive disease. Four patients (32%) developed grade III diarrhea requiring loperamide administration. Two patients (16%) got grade III hematological toxicity requiring hospitalization for blood transfusions and antibiotics. Nausea and vomiting was mild. All nine responders completed six cycles of chemotherapy. The duration of response and survival data is being accrued. Conclusion: The three drug combination is as effective with acceptable toxicity as any other regimen in patients with advanced non-small cell lung cancer.
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