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

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    Authors
    Buchholz, Erika
    Manegold, Christian
    Pilz, Lothar
    Thatcher, Nick
    Drings, Peter
    Affiliation
    Department of Surgery and Interdisciplinary Thoracic Oncology, Klinikum Mannheim, Mannheim, Germany. erika-buchholz@t-online.de
    Issue Date
    2007-01
    
    Metadata
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    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.
    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
    URI
    http://hdl.handle.net/10541/70199
    DOI
    10.1097/JTO.0b013e31802baf9d
    PubMed ID
    17410010
    Type
    Article
    Language
    en
    ISSN
    1556-1380
    ae974a485f413a2113503eed53cd6c53
    10.1097/JTO.0b013e31802baf9d
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