Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis
dc.contributor.author | Buchholz, Erika | |
dc.contributor.author | Manegold, Christian | |
dc.contributor.author | Pilz, Lothar | |
dc.contributor.author | Thatcher, Nick | |
dc.contributor.author | Drings, Peter | |
dc.date.accessioned | 2009-06-11T14:10:11Z | |
dc.date.available | 2009-06-11T14:10:11Z | |
dc.date.issued | 2007-01 | |
dc.identifier.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 | en |
dc.identifier.issn | 1556-1380 | |
dc.identifier.pmid | 17410010 | |
dc.identifier.doi | 10.1097/JTO.0b013e31802baf9d | |
dc.identifier.uri | http://hdl.handle.net/10541/70199 | |
dc.description.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. | |
dc.language.iso | en | en |
dc.subject | Small-Cell Lung Cancer | en |
dc.subject | Chemotherapy | en |
dc.subject.mesh | Adult | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Antineoplastic Combined Chemotherapy Protocols | |
dc.subject.mesh | Carboplatin | |
dc.subject.mesh | Carcinoma, Small Cell | |
dc.subject.mesh | Combined Modality Therapy | |
dc.subject.mesh | Disease Progression | |
dc.subject.mesh | Erythrocyte Transfusion | |
dc.subject.mesh | Etoposide | |
dc.subject.mesh | Female | |
dc.subject.mesh | Filgrastim | |
dc.subject.mesh | Hematopoietic Stem Cell Transplantation | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Ifosfamide | |
dc.subject.mesh | Lung Neoplasms | |
dc.subject.mesh | Male | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Platelet Transfusion | |
dc.subject.mesh | Prognosis | |
dc.subject.mesh | Survival Rate | |
dc.title | Standard versus dose-intensified chemotherapy with sequential reinfusion of hematopoietic progenitor cells in small cell lung cancer patients with favorable prognosis | en |
dc.type | Article | en |
dc.contributor.department | Department of Surgery and Interdisciplinary Thoracic Oncology, Klinikum Mannheim, Mannheim, Germany. erika-buchholz@t-online.de | en |
dc.identifier.journal | Journal of Thoracic Oncology | en |
html.description.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. |