title: Alternating chemotherapy with amrubicin plus cisplatin and weekly administration of irinotecan plus cisplatin for extensive-stage small cell lung cancer.
abstract: BACKGROUND
  A phase II study was conducted in order to determine the tumor efficacy and tolerance of alternating chemotherapy for extensive-stage small cell lung cancer (ED-SCLC).
  
  
  METHODS
  Twenty patients with previously-untreated ED-SCLC were enrolled in the study. At least four courses of chemotherapy consisting of alternation of two drug combinations were given: alternating cycles of amrubicin and cisplatin with weekly administration of irinotecan and cisplatin at 3- or 4-week intervals.
  
  
  RESULTS
  The overall response rate was 85.0% (17/20). The median duration of overall survival and progression-free survival were 359 days and 227 days, respectively. Hematological toxicity was the main adverse event. Grade 3 or 4 neutropenia, thrombocytopenia and anemia were observed in 20 (100%), 4 (20%) and 6 (30%) patients, respectively. With regard to non-hematological adverse events, grade 3 or 4 anorexia, diarrhea, febrile neutropenia and infection were observed in 5 (25%), 2 (10%), 2 (10%) and 2 (10%) patients, respectively. No treatment-related death occurred during either regimen.
  
  
  CONCLUSIONS
  The novel alternating non-cross-resistant chemotherapy was probably active against ED-SCLC and had acceptable toxicities. Further evaluation of this treatment for ED-SCLC in randomized phase III trials is warranted.
authors.affiliation: Department of Clinical Oncology, Tokyo Medical University Hospital, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Noro
authors.forename: Akinobu
authors.initials: A
authors.lastname: Yoshimura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Miyanaga
authors.forename: Hideaki
authors.initials: H
authors.lastname: Mizutani
authors.forename: Yuji
authors.initials: Y
authors.lastname: Minegishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Seike
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kubota
authors.forename: Seiji
authors.initials: S
authors.lastname: Kosaihira
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Hino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ando
authors.forename: Koichiro
authors.initials: K
authors.lastname: Nomura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Okano
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Kazutsugu
authors.initials: K
authors.lastname: Uematsu
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
mesh_terms: D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality
chemical_list: D018943:Anthracyclines; D000077146:Irinotecan; C055866:amrubicin; D002945:Cisplatin; D002166:Camptothecin