Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis
AffiliationDepartment of Surgery and Interdisciplinary Thoracic Oncology, Klinikum Mannheim, Mannheim, Germany. firstname.lastname@example.org
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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.
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 Oncol
JournalJournal of Thoracic Oncology
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- Issue date: 2001 Feb 1
- A threefold dose intensity treatment with ifosfamide, carboplatin, and etoposide for patients with small cell lung cancer: a randomized trial.
- Authors: Leyvraz S, Pampallona S, Martinelli G, Ploner F, Perey L, Aversa S, Peters S, Brunsvig P, Montes A, Lange A, Yilmaz U, Rosti G, Solid Tumors Working Party of the European Group for Blood and Marrow Transplantation.
- Issue date: 2008 Apr 16
- Randomized phase III trial of dose-dense chemotherapy supported by whole-blood hematopoietic progenitors in better-prognosis small-cell lung cancer.
- Authors: Lorigan P, Woll PJ, O'Brien ME, Ashcroft LF, Sampson MR, Thatcher N
- Issue date: 2005 May 4
- Effects of granulocyte-macrophage colony-stimulating factor and dose intensification of V-ICE chemotherapy in small-cell lung cancer: a prospective randomized study of 300 patients.
- Authors: Steward WP, von Pawel J, Gatzemeier U, Woll P, Thatcher N, Koschel G, Clancy L, Verweij J, de Wit R, Pfeifer W, Fennelly J, von Eiff M, Frisch J
- Issue date: 1998 Feb
- Use of high-dose etoposide/ifosfamide/carboplatin/epirubicin and peripheral blood progenitor cell transplantation in limited-disease small cell lung cancer.
- Authors: Brugger W, Frommhold H, Pressler K, Mertelsmann R, Kanz L
- Issue date: 1995 Feb