title: Oral etoposide for Merkel cell carcinoma in patients previously treated with intravenous etoposide.
abstract: We describe three patients with advanced Merkel cell carcinoma who were treated with etoposide given orally for recurrent regional lymph node involvement 18 to 30 months after exposure to etoposide given intravenously. Etoposide given orally (100 mg/day) was given for 10 to 14 consecutive days and repeated every 21 to 28 days for a median of three courses (range: two to four). Toxicity was minimal and mainly hematologic. Two patients showed a complete response and one a partial response, all of very rapid onset. All three patients are alive 6, 9, and 42 months from the start of oral treatment. Two remain progression free, and one had a recurrence 1 month after completion of chemotherapy. We suggest that orally administered etoposide, a topoisomerase II inhibitor, has a strong antitumor effect in advanced Merkel cell carcinoma, even in patients previously treated parenterally with the same drug. This action may be explained by the greater dependence of the drug's efficacy on the duration of administration rather than the dose intensity.
authors.affiliation: Institute of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Fenig
authors.forename: B
authors.initials: B
authors.lastname: Brenner
authors.forename: E
authors.initials: E
authors.lastname: Njuguna
authors.forename: A
authors.initials: A
authors.lastname: Katz
authors.forename: J
authors.initials: J
authors.lastname: Schachter
authors.forename: A
authors.initials: A
authors.lastname: Sulkes
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D015266:Carcinoma, Merkel Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D005047:Etoposide; D002945:Cisplatin