Activity of high-dose epirubicin in advanced non-small cell lung cancer.
24 patients with unresectable non-small cell lung cancer (NSCLC) (14 stage IIIB and 10 stage IV) with a performance status of 70% or higher and without liver metastases received 120-165 mg/m2 epirubicin as an intravenous bolus every 21-28 days up to the maximum cumulative dose of 900 mg/m2. 6 patients (25%) (95% confidence limits 9.8-46.7%) achieved partial remission for a median duration of 7.5 months (range: 3-13+). The median dose actually administered per course was 120 mg/m2 in responsive and non-responsive patients. The dose-limiting side-effect was neutropenia. 1 patient receiving the higher dose died of drug-related infection. Other non-dose-related grade 3 side-effects were alopecia (100%) and vomiting (17%). In 4 patients, the treatment was interrupted because of a greater than 10% reduction in the left ventricular ejection fraction as calculated by radionuclide angiocardiography. None of these patients suffered from cardiac symptoms. The median survival was 10 months (range 1-16). These data suggest that epirubicin at 120-135 mg/m2 may have higher antitumour activity than standard doses in patients with NSCLC. Further studies are needed to clarify whether or not high-dose epirubicin increases, the risk of cardiotoxicity compared to standard doses.
Martoni
A
A
Division of Oncology, S. Orsola-Malpighi Hospital, Bologna, Italy.
Melotti
B
B
Guaraldi
M
M
Pannuti
F
F
D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004341:Drug Evaluation; D015251:Epirubicin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D013318:Stroke Volume / Q000187:drug effects
D015251:Epirubicin