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Oncology (Williston Park). 2004 Jun;18(7 Suppl 4):11-6.

Topoisomerase I inhibitors in small-cell lung cancer. The Japanese experience.

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Division of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.


Among patients with lung cancer, approximately 15% have small-cell lung cancer (SCLC). The clinical characteristics of SCLC tend to be more aggressive, but also more sensitive to chemotherapy and radiation therapy than those of non-SCLC. Irinotecan (Camptosar) is a derivative of camptothecin, an inhibitor of the nuclear enzyme topoisomerase I. Irinotecan has been shown to exhibit excellent antitumor activity against SCLC in monotherapy regimens and in combination with cisplatin. A phase III trial comparing irinotecan and cisplatin (IP) with etoposide and cisplatin (EP) in patients with previously untreated extensive-stage SCLC (ED-SCLC) was conducted. Patients in the IP arm responded significantly better than patients in the EP arm. In the IP arm, the response rate was 84%, and median overall survival was 12.8 months. A phase II trial of irinotecan, cisplatin, and etoposide (IPE) administered weekly (arm A) or every 4 weeks (arm B) for ED-SCLC (JCOG 9902-DI) was also performed. In arm B, the response rate was 77% and the median overall survival was 12.9 months. A randomized trial comparing IP with IPE administered every 3 weeks in patients with previously untreated ED-SCLC is presently being performed in Japan.

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