Phase II study of cisplatin with irinotecan as induction chemotherapy followed by chemoradiotherapy for unresectable stage III non-small cell lung cancer.

Chang, Hyun; Kim, Se Hyun; Cho, Byoung Chul; Yoon, Sang Hyun; Kim, Hye Ryun; Lee, Chang Geol; Kim, Joo Hang
Anticancer research
2012Aug ; 32 ( 8 ) :3515-21.
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Chang, Hyun -
Kim, Se Hyun -
Cho, Byoung Chul -
Yoon, Sang Hyun -
Kim, Hye Ryun -
Lee, Chang Geol -
Kim, Joo Hang -
ABSTRACT
BACKGROUND/AIM: We evaluated the anti-tumor activity and safety of cisplatin with irinotecan (IP) induction chemotherapy followed by chemoradiotherapy with etoposide/cisplatin (EP). PATIENTS AND

METHODS: Induction chemotherapy consisted of irinotecan i.v. and cisplatin i.v. and was administered on day 1 and day 8 of each cycle. Patients underwent two cycles of chemotherapy with a 3-week interval. In the absence of progressive disease, 66 Gy radiation was administered concurrently with etoposide on days 1 to 5 and 29 to 33, as well as with cisplatin on day 1, 8, 29, and 36.

RESULTS: Twenty patients were enrolled between July 2007 and December 2009. This study was closed prematurely due to lack of efficacy in induction chemotherapy. The overall response rate was 45% [95% confidence interval (CI), 25 to 65%], which did not meet the upper limit for first stage rejection of the treatment. The rates of 3-year progression-free survival and overall survival were 17.1% (95% CI, 0 to 36.8%) and 25% (95% CI, 0.2 to 49.8%), respectively. The primary toxicities included neutropenia, diarrhea and fatigue. CONCLUSION: This study failed to demonstrate a benefit for induction chemotherapy which was characterized by suboptimal antitumor activity and was poorly tolerated, with excess treatment-related toxicity.
Aged; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use; Camptothecin/administration & dosage/analogs & derivatives; Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology/radiotherapy; Cisplatin/administration & dosage; Combined Modality Therapy; Disease Progression; Female; Humans; Lung Neoplasms/*drug therapy/pathology/radiotherapy; Male; Middle Aged; Neoplasm Staging
MESH
Aged, Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use, Camptothecin/administration & dosage/analogs & derivatives, Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology/radiotherapy, Cisplatin/administration & dosage, Combined Modality Therapy, Disease Progression, Female, Humans, Lung Neoplasms/*drug therapy/pathology/radiotherapy, Male, Middle Aged, Neoplasm Staging
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Lack of efficacy in induction chemotherapy; Failed to support the use of induction chemotherapy with IP before CRT. More effective chemotherapeutic and biological agents must be developed and investigation of improved radiation therapy must be performed in order to increase the benefit of CRT in unresectable NSCLC
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DOI
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ICD 03
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