Carboplatin-etoposide combination in small cell lung cancer patients older than 70 years: a phase II trial.
BACKGROUND
No standard treatment is defined for elderly patients with small cell lung cancer (SCLC). Carboplatin and etoposide are highly active agents against SCLC. In this study, we evaluated the activity and toxicity of a combination of these two agents.


METHODS
Thirty-four untreated patients with limited or extensive SCLC and median age of 73.9 years entered the study. Chemotherapy consisted of carboplatin i.v. on day 1 (AUC 5 using Calvert's formula) and etoposide 100 mg/m(2) given orally on days 1-5, every 4 weeks, and thoracic irradiation was given to limited disease patients after chemotherapy.


RESULTS
The overall response rates was 59% (95% CI: 43-76). The median survival for all patients was 37 weeks (range 3-76 weeks). The toxicity was mainly haematological with grade 3-4 neutropenia in 59% of courses, febrile neutropenia in 15% of courses, and toxic death in 9% of patients.


CONCLUSIONS
The results of this regimen are disappointing with worse response and survival, and more haematological toxicity than expected and previously reported, despite the use of Calvert's formula. Possible explanations are the use of etoposide per os rather than i.v., the frequent comorbidities of older patients and the inclusion of patients with poor prognosis factors.
Larive
S
S
Service de Pneumologie, Centre Hospitalier Lyon Sud, 69495 Cedex, Pierre Bénite, France.
Bombaron
P
P
Riou
R
R
Fournel
P
P
Perol
M
M
Lena
H
H
Dussopt
C
C
Philip-Joet
F
F
Touraine
F
F
Lecaer
H
H
Souquet
P J
PJ
D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D015996:Survival Rate; D016896:Treatment Outcome
D005047:Etoposide; D016190:Carboplatin