Topoisomerase I inhibitors in small-cell lung cancer. The Japanese experience.
Among patients with lung cancer, approximately 15% have small-cell lung cancer (SCLC). The clinical characteristics of SCLC tend to be more aggressive, but also more sensitive to chemotherapy and radiation therapy than those of non-SCLC. Irinotecan (Camptosar) is a derivative of camptothecin, an inhibitor of the nuclear enzyme topoisomerase I. Irinotecan has been shown to exhibit excellent antitumor activity against SCLC in monotherapy regimens and in combination with cisplatin. A phase III trial comparing irinotecan and cisplatin (IP) with etoposide and cisplatin (EP) in patients with previously untreated extensive-stage SCLC (ED-SCLC) was conducted. Patients in the IP arm responded significantly better than patients in the EP arm. In the IP arm, the response rate was 84%, and median overall survival was 12.8 months. A phase II trial of irinotecan, cisplatin, and etoposide (IPE) administered weekly (arm A) or every 4 weeks (arm B) for ED-SCLC (JCOG 9902-DI) was also performed. In arm B, the response rate was 77% and the median overall survival was 12.9 months. A randomized trial comparing IP with IPE administered every 3 weeks in patients with previously untreated ED-SCLC is presently being performed in Japan.
Saijo
Nagahiro
N
Division of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
Horiike
Atsushi
A
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000077146:Irinotecan; D007564:Japan; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D015996:Survival Rate; D059004:Topoisomerase I Inhibitors
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D004791:Enzyme Inhibitors; D059004:Topoisomerase I Inhibitors; D005047:Etoposide; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin