title: The feasibility study of Carboplatin plus Etoposide for advanced small cell lung cancer with idiopathic interstitial pneumonias.
abstract: BACKGROUND
  Idiopathic interstitial pneumonias (IIPs) are among the most common complications in patients with lung cancer. In such patients with cancer, the most serious expression of toxicity in Japan is acute exacerbation of IIPs caused by anticancer treatment. Nevertheless, there has been no consensus and no evidence presented, regarding optimal treatment for advanced lung cancer with IIP.
  
  
  METHODS
  Chemotherapy-naive patients with advanced small cell lung cancer (SCLC) with IIP who were ineligible for curative radiotherapy were enrolled. Patients received carboplatin every 21 days at a dose of area under the curve 6.0 on day 1 and etoposide at a dose of 100 mg/m on days 1 to 3.
  
  
  RESULTS
  Between July 2002 and October 2008, 17 patients with SCLC with IIP, including 14 men, eight of whom were diagnosed with idiopathic pulmonary fibrosis, were enrolled and treated for a mean of 3.5 cycles of carboplatin plus etoposide. One patient (5.9%; 95% confidence interval, 0-18.4%) with clinically confirmed idiopathic pulmonary fibrosis had acute exacerbation of IIPs associated with the treatment. The overall response rate was 88.2%. The median progression-free survival, median survival time, and 1-year survival rate were 5.5 months, 8.7 months, and 29.4%, respectively.
  
  
  CONCLUSIONS
  This is the first report indicating that patients with advanced SCLC with IIPs may benefit from chemotherapy. Patients with advanced SCLC with IIP treated with etoposide and carboplatin combination chemotherapy gain benefits, with safety equivalent to that seen in patients without IIP. The results from this study would support, on ethical grounds, the conduct of a large-scale study to evaluate this regimen.
authors.affiliation: Division of Pulmonary medicine, Infectious disease, and Oncology, Department of Internal Medicine, Nippon Mediccl School, Tokyo, Japan. yminegis@nms.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Minegishi
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Kuribayashi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizutani
authors.forename: Seiji
authors.initials: S
authors.lastname: Kosaihira
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Okano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Seike
authors.forename: Arata
authors.initials: A
authors.lastname: Azuma
authors.forename: Akinobu
authors.initials: A
authors.lastname: Yoshimura
authors.forename: Shoji
authors.initials: S
authors.lastname: Kudoh
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000150:complications / Q000188:drug therapy*; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D055752:Small Cell Lung Carcinoma / Q000150:complications / Q000188:drug therapy*; D015996:Survival Rate
chemical_list: D005047:Etoposide; D016190:Carboplatin