title: Phase II randomized study of cisplatin plus etoposide phosphate or etoposide in the treatment of small-cell lung cancer.
abstract: OBJECTIVE
  This randomized phase II study evaluated the efficacy and toxicity of etoposide phosphate when used in combination with cisplatin in the treatment of small-cell lung cancer.
  
  
  METHODS
  Patients with previously untreated small-cell lung cancer were randomized to receive cisplatin in combination with either etoposide or etoposide phosphate. Molar-equivalent doses of etoposide and etoposide phosphate were used. Response rate, time to progression, survival, and toxicity were compared.
  
  
  RESULTS
  Major response rates with etoposide phosphate and etoposide were 61% (95% confidence interval, 55% to 67%) and 58% (95% confidence interval, 52% to 64%), respectively (P = .85). No significant differences in median time to progression or survival were observed in patients who received etoposide phosphate versus etoposide. Grade 3 and 4 leukopenia occurred in 63% of patients who received etoposide phosphate compared with 77% who received etoposide (P = .16).
  
  
  CONCLUSIONS
  The combination of etoposide phosphate and cisplatin is effective in the treatment of small-cell lung cancer, and can be administered with acceptable toxicity. Although this study was not designed to be a formal comparative trial, the efficacy and toxicity observed with this regimen were found to be similar to a standard etoposide/cisplatin regimen, using molar-equivalent etoposide doses. Because of its greater ease of administration, etoposide phosphate is preferable to etoposide for routine clinical use.
authors.affiliation: Sarah Cannon-Minnie Pearl Cancer Center, Nashville, TN 37203, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Hainsworth
authors.forename: N
authors.initials: N
authors.lastname: Levitan
authors.forename: G L
authors.initials: GL
authors.lastname: Wampler
authors.forename: C P
authors.initials: CP
authors.lastname: Belani
authors.forename: M S
authors.initials: MS
authors.lastname: Seyedsadr
authors.forename: J
authors.initials: J
authors.lastname: Randolph
authors.forename: L P
authors.initials: LP
authors.lastname: Schacter
authors.forename: F A
authors.initials: FA
authors.lastname: Greco
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis
chemical_list: D009943:Organophosphorus Compounds; C061400:etoposide phosphate; D005047:Etoposide; D002945:Cisplatin