Irinotecan in cancers of the lung and cervix.
Irinotecan is active as a single agent in advanced non-small cell lung cancer (NSCLC), with overall response rates (ORRs) of 13-32% reported in phase II trials. In the first-line treatment of stage III/IV NSCLC, phase II studies have suggested that the combination of irinotecan with cisplatin can achieve response rates of 29-75%, which is greater than achieved with older platinum-containing combinations. Neutropenia and diarrhea are the dose-limiting toxicities. In small cell lung cancer (SCLC), irinotecan alone has achieved ORRs of 16-47% in previously treated SCLC, which is higher than expected with oral etoposide. Studies with irinotecan in combination with cisplatin or etoposide have reported responses of up to 79%. Irinotecan is active in cervical cancer patients whose metastases are outside the area of previous irradiation (ORR 24%) and a major phase II/III study is currently comparing irinotecan as single agent or in combination with cisplatin against a reference cisplatin arm.
Sandler
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Indiana University School of Medicine, Indianapolis, USA. asandler@iupui.edu
van Oosterom
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D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy*
D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin