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Lung Cancer. 2009 Nov;66(2):226-30. doi: 10.1016/j.lungcan.2009.02.003. Epub 2009 Mar 24.

Topotecan-carboplatin-etoposide combination as 1st line treatment in patients with small cell lung cancer.

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Lung Tumour Research Section, University Pulmonary Clinic, Aristotle Univ. of Thessaloniki, G. Papanicolaou Hospital, Greece.



To test toxicity, tolerability, time to progression, survival and response rate in the 3-day administration of topotecan (T) followed by carboplatin (C), and then etoposide (E) in a study for small cell lung cancer (SCLC) treatment.


44 chemotherapy-naive patients with SCLC (median age 63.5, PS 0-1). ED was present in 28 patients.


Each treatment cycle consisted of T (0.8 mg/m(2) on days 1-3), C (AUC=5, day 3) and a standard oral dose of E (100mg on days 15-17). Cycles were repeated every 32 days and up to eight were performed. Responders received radiotherapy to the primary site (50 Gy) after the 4th cycle and complete responders also received PCI.


Complete response (CR) was achieved in 4 patients, partial response (PR) in 18, stable disease in 10 and PD in 12. Median survival was 280 (+/-36.7) days and median time to progression 137 days. 11 patients developed grade 3/4 neutropenia and 3 patients grade 3/4 anaemia. Non-haematological toxicity was mild.


In contrast to ORR, PFS and survival were quite similar to those of SCLC patients suffering from ED treated by a platinum-etoposide regimen. The T/C/E combination was well tolerated and with low toxicity, but without improvement in the ORR and survival in comparison to platinum analogue regimes.

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