Irinotecan and cisplatin with concurrent thoracic radiotherapy in a once-every-three-weeks schedule in patients with limited-disease small-cell lung cancer : a phase I study

de Jong, W.X.; de Jonge, M.J.A.; van der Leest, A.H.D.; van Meerbeeck, J.P.; Groen, H.J.M.

doi:10.1016/J.LUNGCAN.2007.11.010

Title

Irinotecan and cisplatin with concurrent thoracic radiotherapy in a once-every-three-weeks schedule in patients with limited-disease small-cell lung cancer : a phase I study

Author

de Jong, W.X.

de Jonge, M.J.A.

van der Leest, A.H.D.

van Meerbeeck, J.P.

Groen, H.J.M.

Abstract

Background: Irinotecan and cisplatin with concurrent radiotherapy is a powerful treatment combination for patients with limited-disease small-cell lung cancer (LD-SCLC). The objective was to determine the dose-limiting toxicity (DLT) and maximum-tolerated dose (MTD) of irinotecan and cisplatin with concurrent thoracic radiotherapy (TRT) as a once-every-three-weeks schedule. Patients and methods: Patients with LD-SCLC received a fixed-dose of irinotecan (340 mg) and cisplatin (135 mg) at day 1 in cycles 1 and 4. During cycles 2 and 3, irinotecan and cisplatin were given in a dose-escalation schedule with concurrent TRT (once daily, total dose 45Gray). Results: No DLT was observed at first two levels (irinotecan 100mg or 120mg and cisplatin 100mg at day 1 of cycles 2 and 3). In the first five patients, four episodes of grade III diarrhoea/dehydration were observed at cycles 1 and 4. Therefore, from the sixth patient on, fixed-dose irinotecan at cycles 1 and 4 was reduced to 250mg. At the subsequent level of irinotecan 140mg and cisplatin 100mg in cycles 2 and 3, two DLTs (severe oesophagitis and late vertebral. radiation toxicity) were observed in one patient. Conclusion: Irinotecan 140mg and cisplatin 100mg with concurrent TRT was considered the MTD. Irinotecan and cisplatin in a once-every-three-weeks schedule is not recommended due to severe toxicity. Irinotecan may be more suited for intermittent weekly administration. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

Language

English

Source (journal)

Lung cancer: journal of the International Association for the Study of Lung Cancer / International Association for the Study of Lung Cancer [Aurora, Colo.] - Amsterdam

Publication

Amsterdam : 2008

ISSN

0169-5002

DOI

10.1016/J.LUNGCAN.2007.11.010

Volume/pages

61 :1 (2008) , p. 123-128

ISI

000257934400017

Full text (Publisher's DOI)

https://doi.org/10.1016/J.LUNGCAN.2007.11.010