Cisplatin Plus Oral Etoposide in the Treatment of Patients with Advanced Small Cell Lung Cancer

Background: Etoposide is a highly schedule-dependent drug. We investigated combination chemotherapy of oral etoposide and intravenous cisplatin for small cell lung cancer (SCLC). Methods: Fifty-seven patients withSCLCwithextensive disease (ED)or limited disease(LD)with pleural effusion registered in the 21 institutions of the JapanClinical Oncology Groupweretreated with oral etoposide 40 mg/m 2/d for 21 days and cisplatin 80 mg/m 2 on day 1 of every28-period day. The entry period was between February 1992 and August 1995.The actualpercentages of patients treated with etoposide were 93.6, 89.5, 92.3 and 96.9% in the first, second, third and fourth cycles, respectively. Results: Nine patients(15.8%) achieved a complete response resulting in an overall response rateof 82.5%(95%confidence interval, 70.1-91.3%). Leukopenia andthrombocytopenia of grade 3 or 4 were observed in 36 (49.1%) and 8 (14.0%) patients, respectively. Anemia of grade 3 or 4 occurred in 28 (49.1 %) patients. Nausea, vomiting, anorexia and alopecia were common adverse events. One patient died of hemoptysis due to grade 4 thrombocytopenia.The mean survival time was 47.0 weeks. Conclusions: Thisdoseandschedule of administration of etoposide in combination withcisplatin areconsidered to beclinically active. However, prolonged gastrointestinal toxicityof oraletoposide was a problem in comparison withthe standard etoposide platinum regimen givenby intravenous administration.