Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis

2.50
Hdl Handle:
http://hdl.handle.net/10541/70199
Title:
Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis
Authors:
Buchholz, Erika; Manegold, Christian; Pilz, Lothar; Thatcher, Nick; Drings, Peter
Abstract:
PURPOSE: The combination of ifosfamide, carboplatin, and etoposide (ICE) is highly effective in treating small cell lung cancer (SCLC). Myelosuppression resulting in leukopenia and thrombocytopenia is the dose-limiting toxicity. PATIENTS AND METHODS: This phase 3 study assessed 2-year survival improvement with dose intensification of ICE chemotherapy (ICT) in patients with good-prognosis SCLC. Patients received up to six cycles of ICT with filgrastim-supported sequential reinfusion of peripheral blood progenitor cells every 14 days, or standard ICE (SCT) every 28 days. RESULTS: Eighty-three patients were randomized to ICT (n = 42) or SCT (n = 41). Median survival was significantly improved with ICT (30.3 mo) versus SCT (18.5 mo; p = 0.001); 2-year survival was 55% for ICT and 39% for SCT (p = 0.151). Time to progression (TTP) was significantly improved, with 15 months for ICT versus 11.1 months for SCT (p = 0.0001). Overall response rates were 100 and 88% for ICT and SCT, respectively (p = 0.0258). SCT was associated with significantly less grade 3 and 4 leukopenia at day 8 (p < 0.0001), less thrombocytopenia at day 14 (p < 0.0001), and more favorable platelet nadir (p < 0.0001). The need for platelet and red blood cell transfusions significantly increased in the ICT group (p < 0.0001). Nonhematologic adverse events in both groups were comparable and mostly grade 1 or 2. CONCLUSION: Patients receiving ICT with filgrastim achieved significant increases in median survival and TTP despite an increased need for transfusions.
Affiliation:
Department of Surgery and Interdisciplinary Thoracic Oncology, Klinikum Mannheim, Mannheim, Germany. erika-buchholz@t-online.de
Citation:
Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis. 2007, 2 (1):51-8 J Thorac Oncol
Journal:
Journal of Thoracic Oncology
Issue Date:
Jan-2007
URI:
http://hdl.handle.net/10541/70199
DOI:
10.1097/JTO.0b013e31802baf9d
PubMed ID:
17410010
Type:
Article
Language:
en
ISSN:
1556-1380
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBuchholz, Erika-
dc.contributor.authorManegold, Christian-
dc.contributor.authorPilz, Lothar-
dc.contributor.authorThatcher, Nick-
dc.contributor.authorDrings, Peter-
dc.date.accessioned2009-06-11T14:10:11Z-
dc.date.available2009-06-11T14:10:11Z-
dc.date.issued2007-01-
dc.identifier.citationStandard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis. 2007, 2 (1):51-8 J Thorac Oncolen
dc.identifier.issn1556-1380-
dc.identifier.pmid17410010-
dc.identifier.doi10.1097/JTO.0b013e31802baf9d-
dc.identifier.urihttp://hdl.handle.net/10541/70199-
dc.description.abstractPURPOSE: The combination of ifosfamide, carboplatin, and etoposide (ICE) is highly effective in treating small cell lung cancer (SCLC). Myelosuppression resulting in leukopenia and thrombocytopenia is the dose-limiting toxicity. PATIENTS AND METHODS: This phase 3 study assessed 2-year survival improvement with dose intensification of ICE chemotherapy (ICT) in patients with good-prognosis SCLC. Patients received up to six cycles of ICT with filgrastim-supported sequential reinfusion of peripheral blood progenitor cells every 14 days, or standard ICE (SCT) every 28 days. RESULTS: Eighty-three patients were randomized to ICT (n = 42) or SCT (n = 41). Median survival was significantly improved with ICT (30.3 mo) versus SCT (18.5 mo; p = 0.001); 2-year survival was 55% for ICT and 39% for SCT (p = 0.151). Time to progression (TTP) was significantly improved, with 15 months for ICT versus 11.1 months for SCT (p = 0.0001). Overall response rates were 100 and 88% for ICT and SCT, respectively (p = 0.0258). SCT was associated with significantly less grade 3 and 4 leukopenia at day 8 (p < 0.0001), less thrombocytopenia at day 14 (p < 0.0001), and more favorable platelet nadir (p < 0.0001). The need for platelet and red blood cell transfusions significantly increased in the ICT group (p < 0.0001). Nonhematologic adverse events in both groups were comparable and mostly grade 1 or 2. CONCLUSION: Patients receiving ICT with filgrastim achieved significant increases in median survival and TTP despite an increased need for transfusions.en
dc.language.isoenen
dc.subjectSmall-Cell Lung Canceren
dc.subjectChemotherapyen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshCarboplatin-
dc.subject.meshCarcinoma, Small Cell-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshDisease Progression-
dc.subject.meshErythrocyte Transfusion-
dc.subject.meshEtoposide-
dc.subject.meshFemale-
dc.subject.meshFilgrastim-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshIfosfamide-
dc.subject.meshLung Neoplasms-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPlatelet Transfusion-
dc.subject.meshPrognosis-
dc.subject.meshSurvival Rate-
dc.titleStandard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosisen
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery and Interdisciplinary Thoracic Oncology, Klinikum Mannheim, Mannheim, Germany. erika-buchholz@t-online.deen
dc.identifier.journalJournal of Thoracic Oncologyen

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