National Cancer Institute®
Last Modified: May 1, 2002
UI - 11784874
AU - Noda K; Nishiwaki Y; Kawahara M; Negoro S; Sugiura T; Yokoyama A;
TI - Fukuoka M; Mori K; Watanabe K; Tamura T; Yamamoto S; Saijo N; The Japan Clinical Oncology Group Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer.
SO - N Engl J Med 2002 Jan 10;346(2):85-91
AD - Kanagawa Cancer Center, Yokohama, Japan.
BACKGROUND: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. In a phase 2 study of irinotecan plus cisplatin in patients with extensive small-cell lung cancer, there was a high response rate and a promising median survival time. METHODS: We conducted a multicenter, randomized, phase 3 study in which we compared irinotecan plus cisplatin with etoposide plus cisplatin in patients with extensive (metastatic) small-cell lung cancer. RESULTS: The planned size of the study population was 230 patients, but enrollment was terminated early because an interim analysis found a statistically significant difference in survival between the patients assigned to receive irinotecan and cisplatin and those assigned to receive etoposide and cisplatin; as a result, only 154 patients were enrolled. The median survival was 12.8 months in the irinotecan-plus-cisplatin group and 9.4 months in the etoposide-plus-cisplatin group (P=0.002 by the unadjusted log-rank test). At two years, the proportion of patients surviving was 19.5 percent in the irinotecan-plus-cisplatin group and 5.2 percent in the etoposide-plus-cisplatin group. Severe or life-threatening myelosuppression was more frequent in the etoposide-plus-cisplatin group than in the irinotecan-plus-cisplatin group, and severe or life-threatening diarrhea was more frequent in the irinotecan-plus-cisplatin group than in the etoposide-plus-cisplatin group. CONCLUSIONS: Irinotecan plus cisplatin is an effective treatment for metastatic small-cell lung cancer.
UI - 11986422
AU - Ando Y; Figg WD
TI - Irinotecan in small-cell lung cancer.
SO - N Engl J Med 2002 May 2;346(18):1414-5; discussion 1414-5
UI - 11978328
AU - Coleman RE
TI - Value of FDG-PET scanning in management of lung cancer.
SO - Lancet 2002 Apr 20;359(9315):1361-2
AD - Division of Nuclear Medicine, Department of Radiology, Duke University Medical School, Durham NC 27710, USA. email@example.com
UI - 11782709
AU - Lorusso V; Crucitta E
TI - [New therapeutic prospects in microcytoma]
SO - Minerva Endocrinol 2001 Dec;26(4):239-41
AD - Oncologia Medica, Istituto Oncologico, Bari, Italy.
The therapeutic efforts of the past thirty years have been directed at improving the scant prognosis of patients suffering from microcytoma (SCLC) using a combination of chemotherapy and radiotherapy. Studies have shown that the longest survival rates are achieved when radiotherapy is administered concomitantly with chemotherapy. No clear correlation has been identified between the 3-year disease-free survival rate and the type of chemotherapy used. The standard treatment for patients suffering from SCLC is currently polychemotherapy using protocols with cisplatin, with or without radiotherapy. Among the new protocols that have been proposed, an increase in dose intensity, weekly therapy and alternating chemotherapy appear to give the most promising results, even if no studies have so far actually demonstrated their ability to improve results.
UI - 11782710
AU - Puma F; Urbani M; Santoprete S; Ricci F; Sanguinetti A; Vinci D; Ottavi
TI - P; Porcaro G; Daddi G [The role of surgery in the treatment of small cell lung cancer]
SO - Minerva Endocrinol 2001 Dec;26(4):247-53
AD - Chirurgia Toracica, Ospedale Civile S. Maria, Terni, Universita degli Studi, Perugia, Italy. firstname.lastname@example.org
Small cell lung cancer (SCLC) is a biologically aggressive tumor with a low long-term survival rate. SCLC is highly responsive to chemotherapy and surgery has a very limited role in its treatment because the disease is usually widely disseminated at the diagnosis. Good results from surgery have been reported in the small subgroup of T1-2 N0 M0 patients. In N1 peripheral SCLC, surgery in combination with other treatments, can obtain fair results. Surgical treatment does not influence the prognosis in SCLC as stage III and IV.
UI - 11782711
AU - Busutti L
TI - [Current role of radiotherapy in the treatment of SCLC]
SO - Minerva Endocrinol 2001 Dec;26(4):255-60
AD - U.O. Radioterapia, Azienda Ospedaliera S. Orsola-Malpighi, Bologna, Italy.
Microcytoma (SCLC) is generally regarded as a disease requiring chemotherapy and is only treated with radiotherapy using combined protocols. A number of different approaches have been proposed, changing timing, dose and fractionation. A different role is played by irradiation of the brain in the treatment of metastases. The authors discuss the role of radiotherapy in the treatment of SCLC and in study protocols through an analysis of a personal series.
UI - 11782712
AU - Comella G; Panza N
TI - [New therapeutic strategies in microcytoma]
SO - Minerva Endocrinol 2001 Dec;26(4):261
AD - Divisione di Oncologia Medica A, Istituto Nazionale dei Tumori, Naples, Italy.
UI - 11782713
AU - Pastore V; Santini M; Vicidomini G; D'Aniello G; Fiorello A;
TI - Parascandolo V [Role of the surgeon in the treatment of small cell lung carcinoma]
SO - Minerva Endocrinol 2001 Dec;26(4):263-7
AD - Dipartimento di Scienze Cardio-Toraciche e Respiratorie, Cattedra di Chirurgia Toracica, Seconda Universita degli Studi, Naples, Italy.
Surgery has never played a precise and well consolidated role in the planned treatment of lung microcytoma (SCLC). The acknowledged therapeutic strategy associates local treatment (radiotherapy) with general treatment (chemotherapy). Exeresis is particularly indicated in limited or peripheral forms, followed by intensive polychemotherapy. Scintigraphy with octreotide may be used for the initial screening of patients with widespread disease. Another minor role played by surgery is in the treatment of neoplastic foci remaining after chemotherapy. In some cases the use of a radioguided method which, after intravenous injection of radiolabeled octreotide, allows the accumulation of somatostatin analog in neoplastic foci to be assayed intraoperatively using a manual probe, might help the surgeon to check the radical nature of the operation. In addition, octreotide can be used as a radiotherapeutic pharmacological agent or to enhance the efficacy of chemotherapy in microcytoma and other lung tumours with neuroendocrine differentiation.
UI - 11842350
AU - Thomas M; Baumann M; Deppermann M; Freitag L; Gatzemeier U; Huber R;
TI - Passlick B; Serke M; Ukena D [Recommendations on the therapy of bronchial carcinoma]
SO - Pneumologie 2002 Feb;56(2):113-31
AD - Klinik fur Hamatologie, Onkologie und Pneumologie, Medizinische Klinik A, Universitatsklinikum Munster, Germany. email@example.com
UI - 10478250
AU - Marom EM; McAdams HP; Erasmus JJ; Goodman PC; Culhane DK; Coleman RE;
TI - Herndon JE; Patz EF Jr Staging non-small cell lung cancer with whole-body PET.
SO - Radiology 1999 Sep;212(3):803-9
AD - Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
PURPOSE: To compare the accuracies of whole-body 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) and conventional imaging (thoracic computed tomography [CT], bone scintigraphy, and brain CT or magnetic resonance [MR] imaging) in staging bronchogenic carcinoma. MATERIALS AND METHODS: Within 20 months, 100 patients with newly diagnosed bronchogenic carcinoma underwent whole-body FDG PET and chest CT. Ninety of these patients underwent radionuclide bone scintigraphy, and 70 patients underwent brain CT or MR imaging. For each patient, all examinations were completed within 1 month. A radiologic stage was assigned by using PET and conventional imaging independently and was compared with the pathologic stage. The accuracy, sensitivity, specificity, and negative and positive predictive values were calculated. RESULTS: PET staging was accurate in 83 (83%) patients; conventional imaging staging was accurate in 65 (65%) patients (P < .005). Staging with mediastinal lymph nodes was correct by using PET in 67 (85%) patients and by using CT in 46 (58%) patients (P < .001). Nine (9%) patients had metastases demonstrated by using PET that were not found with conventional imaging, whereas 10 (10%) patients suspected of having metastases because of conventional imaging findings were correctly shown with PET to not have metastases. CONCLUSION: Whole-body PET was more accurate than thoracic CT, bone scintigraphy, and brain CT or MR imaging in staging bronchogenic carcinoma.
UI - 11973641
AU - Koshikawa K; Osada H; Kozaki K; Konishi H; Masuda A; Tatematsu Y;
TI - Mitsudomi T; Nakao A; Takahashi T Significant up-regulation of a novel gene, CLCP1, in a highly metastatic lung cancer subline as well as in lung cancers in vivo.
SO - Oncogene 2002 Apr 25;21(18):2822-8
AD - Division of Molecular Oncology, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
Most lung cancer patients are unfortunately uncurable and die because of widespread metastases, thus indicating the importance of identification of molecules with a crucial role in this process. Our previous expression profiling analysis of a highly metastatic lung cancer cell line, NCI-H460-LNM35, and its parental low metastatic line, NCI-H460-N15, revealed significant up-regulation of both known and unknown genes in LNM35. In this study, we describe the isolation and detailed characterizations of a novel gene, named CLCP1, which corresponds to one of such expression sequence tags with up-regulated expression in LNM35. The CLCP1 gene was found to encode a protein with 775 amino acids with structural similarities to, but distinct from neuropilins, cell surface receptors for VEGF165 and semaphorins. Notably, CLCP1 was shown to be up-regulated not only in LNM35 in association with its acquisition of metastatic phenotype during in vivo selection, but also in a significant fraction of lung cancers in vivo with high frequency in metastatic lesions, warranting future studies for a better understanding of the molecular mechanisms of lung cancer metastasis.
UI - 11804379
AU - Gridelli C; Perrone F; Nelli F; Ramponi S; De Marinis F
TI - Quality of life in lung cancer patients.
SO - Ann Oncol 2001;12 Suppl 3():S21-5
AD - Divisione di Oncologia Medica B, Istituto Nazionale Tumori, Naples, Italy. firstname.lastname@example.org
The quality of life of lung cancer patients is affected by several factors related to the patients, stage of disease and treatment characteristics. For small-cell lung cancer (SCLC), the treatment is generally aggressive, primarily based on chemotherapy. Treatment strategy for non-small-cell lung cancer (NSCLC) is strongly dependent on the stage of the disease and ranges from surgery to palliative chemotherapy. Over the last few years, very little progress has been made in terms of survival. Therefore, the effect of treatment on quality of life has become progressively more relevant. Among the instruments for measuring quality of life, there are some specifically developed for lung cancer, such as the European Organization for Research and Treatment of Cancer (EORTC) LC-13 questionnaire, the Functional Assessment of Cancer Therapy (FACT-L) questionnaire and the Lung Cancer Symptom Scale (LCSS). Up to now, few randomised clinical trials have correctly evaluated quality of life. There are evident pitfalls associated with the use of frequently non-validated tools, and poor methods of data analysis, but quality-of-life evaluation is crucial and should be addressed through well-planned and well-conducted prospective clinical trials.
UI - 11796233
AU - Gridelli C; De Vivo R; Monfardini S
TI - Management of small-cell lung cancer in the elderly.
SO - Crit Rev Oncol Hematol 2002 Jan;41(1):79-88
AD - Unita Operativa di Oncologia Medica B, Istituto Nazionale Tumori, Via M. Semmola 3, 80131 Naples, Italy. email@example.com
More than 50% of lung cancer patients are diagnosed over the age of 65 and about 30% over 70. Small-cell lung cancer (SCLC) accounts for 20-25% of lung carcinomas. Chemotherapy is the cornerstone of treatment for SCLC. Usually in the elderly it is difficult to administer the same chemotherapy administered to younger patients because elderly patients tolerate chemotherapy poorly. The empirical reduction of drug doses may be criticized. The best approach is to design specific trials in order to develop active and well-tolerated chemotherapy regimens for SCLC elderly patients. The standard therapy in limited disease is combined chemo-radiotherapy followed by prophylactic brain irradiation for patients achieving a complete response. In the elderly, the addition of radiotherapy to chemotherapy must be accurately evaluated, considering the slight survival improvement and the potential relevant toxicity.
UI - 11930699
AU - Jin B; Zhao L; Zhou C
TI - [The prognostic value of serum neuron specific enolase detection in small cell lung cancer]
SO - Zhonghua Jie He He Hu Xi Za Zhi 2001 Dec;24(12):722-4
AD - Department of Medicine, Shanghai Pneumology Hospital, Shanghai 200433, China.
OBJECTIVE: To evaluate the prognostic value of NSE detection in small cell lung cancer. METHODS: 144 unresectable small cell lung cancer patients were eligible in the retrospective study. NSE was analyzed before chemotherapy and 21 days after chemotherapy using ELISA method. RESULTS: For D1-NSE, 98 (68.1%) were NSE positive and 46(31.9%) were NSE negative; for D21-NSE, 57(39.6%) were NSE positive and 87 (60.4%) were NSE negative. In univariate analysis, both D1-NSE and D21-NSE have prognostic significance. But in multivariate analysis only D21-NSE is an independent prognostic factor. CONCLUSION: D21-NSE in small cell lung cancer is an independent prognostic factor and may be proposed for use in the clinic and research.
UI - 11989911
AU - Paccagnella A; Oniga F; Favaretto A; Biason R; Ghi MG
TI - Elderly patients with small cell lung cancer.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S145-7
AD - Oncology Unit, Venice Hospital.
UI - 11099281
AU - The AM; Hak T; Koeter G; van Der Wal G
TI - Collusion in doctor-patient communication about imminent death: an ethnographic study.
SO - BMJ 2000 Dec 2;321(7273):1376-81
AD - See also Education and debate p 1400 Institute for Research in Extramural Medicine/Department of Social Medicine, Vrije Universiteit, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. firstname.lastname@example.org
OBJECTIVE: To discover and explore the factors that result in "false optimism about recovery" observed in patients with small cell lung cancer. DESIGN: A qualitative observational (ethnographic) study in two stages over four years. SETTING: Lung diseases ward and outpatient clinic in university hospital in the Netherlands. PARTICIPANTS: 35 patients with small cell lung cancer. RESULTS: "False optimism about recovery" usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. "False optimism about recovery" was the result an association between doctors' activism and patients' adherence to the treatment calendar and to the "recovery plot," which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a "death sentence" and the patient did and did not want to hear it. CONCLUSION: Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself - for example, by involving "treatment brokers."
UI - 11914903
AU - Sadava D; Ahn J; Zhan M; Pang ML; Ding J; Kane SE
TI - Effects of four Chinese herbal extracts on drug-sensitive and multidrug-resistant small-cell lung carcinoma cells.
SO - Cancer Chemother Pharmacol 2002 Apr;49(4):261-6
AD - Division of Molecular Medicine, City of Hope Medical Center, 1500 E. Duarte Rd., Duarte, CA 91010, USA. email@example.com
PURPOSE: We examined the pharmacology, cell biology and molecular biology of small-cell lung carcinoma cells treated with four extracts of Chinese herbal medicines. Many cancer patients take these medicines, but their effects at the cellular level are largely unknown. We were especially interested in the effects on drug-resistant cells, as resistance is a significant clinical problem in lung cancer. METHODS: Drug-sensitive (H69), multidrug-resistant (H69VP) and normal lung epithelial cells (BEAS-2) were exposed to extracts from two plants used in Chinese herbal medicine for lung cancer: Glycorrhiza glabra (GLYC) and Olenandria diffusa (OLEN), and to extracts of two commercially available combinations of Chinese herbal medicines, SPES (15 herbs) and PC-SPES (8 herbs). Cytotoxicity was measured in terms of cell growth inhibition (IC(50)). The kinetics of DNA fragmentation after exposure to the herbal extracts was measured by BudR labeling followed by ELISA. Apoptosis was measured by the TUNEL assay followed by flow cytometry. Expression of apoptosis- and cell cycle-related genes was measured by reverse transcription of mRNA followed by filter hybridization to arrays of probes and detection by chemiluminescence. RESULTS: In each case, the four herbal extracts were equally cytotoxic to H69 and H69VP and less cytotoxic to BEAS-2. All four extracts induced DNA fragmentation in the lung carcinoma cells. The kinetics showed DNA fragments released to the medium (an indication of necrosis) in GLYC-exposed cultures, but inside the cells (an indication of apoptosis) in OLEN-, SPES- and PC-SPES-exposed cultures. TUNEL analysis confirmed that exposure to the latter three extracts, but not to GLYC, led to apoptosis. Compared to untreated and GLYC-treated cells, H69 and H69VP cells treated with OLEN, SPES and PC-SPES showed elevated expression of a number of genes involved in the apoptotic cascade, similar to cells treated with etoposide and vincristine. CONCLUSION: The Chinese herbal medicine extracts OLEN, SPES and PC-SPES are cytotoxic to both drug-resistant and drug-sensitive lung cancer cells, show some tumor cell specificity compared to their effect on normal cells, and are proapoptotic as measured by DNA breaks and gene expression. The reaction of the tumor cells to these extracts was similar to their reaction to conventional chemotherapeutic drugs.
UI - 11839685
AU - Maulik G; Kijima T; Ma PC; Ghosh SK; Lin J; Shapiro GI; Schaefer E;
TI - Tibaldi E; Johnson BE; Salgia R Modulation of the c-Met/hepatocyte growth factor pathway in small cell lung cancer.
SO - Clin Cancer Res 2002 Feb;8(2):620-7
AD - Department of Adult Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA.
The c-Met receptor tyrosine kinase and its ligand HGF (hepatocyte growth factor) have been shown to be involved in angiogenesis, cellular motility, growth, invasion, and differentiation. The role of c-Met/HGF axis in small cell lung cancer (SCLC) has not been reported previously. We have determined the expression of p170(c-Met) precursor and p140(c-Met) beta-chain in seven SCLC cell lines by immunoblotting. We used the SCLC cell line H69, which expressed an abundant amount of c-Met to study the function and downstream effects of c-Met activation. Stimulation of H69 cells with HGF (40 ng/ml, 6-h stimulation) significantly altered cell motility of the SCLC cells with increased formation of filopodia and membrane ruffling, characterized as membrane blebbing, as well as increased migration of the cellular clusters were seen. We have further studied the signal transduction pathways of HGF/c-Met in the H69 cell line. The stimulation of H69 with HGF (40 ng/ml, >24 h, maximal at 1 h) increased the amount of reactive oxygen species formed by 34%. HGF stimulation (40 ng/ml, 7.5-min stimulation) of H69 cells showed increased tyrosine phosphorylated bands identified at M(r) 68,000, 120,000-140,000, and 200,000. Some of these tyrosine-phosphorylated bands were identified as the focal adhesion proteins paxillin, FAK, PYK2, and the c-Met receptor itself. Phospho-specific antibodies show that tyrosines at amino acid (a.a.) 31 of paxillin, and autophosphorylation sites at a.a. 397 of p125FAK, and a.a. 402 of PYK2 are phosphorylated in response to HGF/c-Met signaling. We also demonstrate that the Hsp90 inhibitor geldanamycin, which also affects c-Met, reduced the growth and viability of four of four SCLC cell lines by 25% to 85%, over a 72-h time period. Geldanamycin caused apoptosis of SCLC cells, as well as led to increased levels of Hsp70 but not Hsp90. These results demonstrate that c-Met/HGF pathway is functional in SCLC, and it would be useful to target this pathway toward novel therapy.
UI - 11928694
AU - Bohrer M; Wenz F
TI - Prophylactic cranial irradiation in limited-disease small-cell lung cancer - why, when, how much?
SO - Onkologie 2002 Feb;25(1):66-8
AD - Sektion Strahlentherapie, Universitatsklinikum Mannheim, Germany.
UI - 11935310
AU - Hrabec E; Strek M; Nowak D; Greger J; Suwalski M; Hrabec Z
TI - Activity of type IV collagenases (MMP-2 and MMP-9) in primary pulmonary carcinomas: a quantitative analysis.
SO - J Cancer Res Clin Oncol 2002 Apr;128(4):197-204
AD - Department of Medical Biochemistry, Medical University of Lodz 90-131, Lodz Lindleya 6, Poland. firstname.lastname@example.org
PURPOSE: Matrix metalloproteinases MMP-2 and MMP-9 are implicated in invasion and metastasis of malignant tumors. We investigated the expression and activation of MMP-2 and MMP-9 in lung cancer compared with normal lung parenchyma, and looked for a potential marker of malignancy. METHODS: Thirty-six pulmonary carcinomas and paired normal lung specimens were analyzed by gelatin zymography and computer-assisted image analysis for the expression of MMP-2 and MMP-9. RESULTS: We showed that expression of both type IV collagenases was remarkably higher in carcinoma samples than in lung parenchyma. The MMP-9 levels in lung cancer were over twofold higher than in normal lung tissues. The levels of latent and active forms of MMP-2 in lung cancer samples were, correspondingly, 3.8- and 17-fold higher than in lung parenchyma. The tumor/normal (T/N) ratios of MMP-2 were negatively correlated with the hemoglobin levels and erythrocytes number. CONCLUSIONS: A high level of the active form of MMP-2 in almost all of the carcinomas and the near lack of its activation in normal lung parenchyma shows that MMP-2 activation is associated with the malignant phenotype and may serve as a good marker of malignancy. The correlation between low hemoglobin level and T/N ratio of MMP-2 may indicate significance of MMP-2 for angiogenesis.
UI - 11802803
AU - Morita T
TI - A statistical study of lung cancer in the annual of pathological autopsy cases in Japan, from 1958 to 1997, with reference to time trends of lung cancer in the world.
SO - Jpn J Cancer Res 2002 Jan;93(1):15-23
AD - Department of Pathology, International Medical Center of Japan, Shinjuku-ku, Tokyo 162-8655, Japan. moritath.@zf6.so-net.ne.jp
Lung cancer cases (66650 males and 20890 females) registered in the Annual of Pathological Autopsy Cases in Japan, between 1958 and 1997, were analyzed with regard to sex, age and histology. They were subdivided into decades (periods I to IV), and compared with the Japanese mortality statistics, with which they were in good correspondence. Although the autopsy rate is decreasing, more than 10% of the total lung cancer deaths in Japan were registered by 1990. Among autopsied cases, the incidence of lung cancer cases increased from 6% to 12% in males and from 3% to 6% in females. From period III, lung cancer in males became the most frequent, and was the second most frequent cancer in females after gastric cancer. As for the histological distribution, adenocarcinoma was the most frequent and squamous cell carcinoma was the next most frequent in both sexes. Recently, a significant increase in adenocarcinoma and a significant decrease in squamous cell carcinoma have been observed in both sexes. The peak ages shifted from the 60s to the 70s and a significant rise in the mean ages were observed. The male-to-female ratios and the ratio curves by histological and age group were high for squamous cell carcinoma and small cell carcinoma, while they were low for the total and adenocarcinoma. With the recently acquired data on lung cancer in Asian countries, and from the male-to-female ratios and the status of smoking rates, lung cancer in the world at present was divided into three groups; North America, Europe and Asia. The possibility of one group changing to resemble another and of groups converging in the near future is suggested.
UI - 11763820
AU - Potanin VP; Taziev RM; Sigal EI; Krasin VV; Khalimov ID; Potanin AV;
TI - Sigal RI; Latypov AG [Thienam treatment in early postoperative period after pneumonectomy in patients with lung cancer]
SO - Khirurgiia (Mosk) 2001;(10):47-8
UI - 11750705
AU - Larive S; Bombaron P; Riou R; Fournel P; Perol M; Lena H; Dussopt C;
TI - Philip-Joet F; Touraine F; Lecaer H; Souquet PJ; Groupe Lyon-Saint Etienne d'Oncologie Thoracique Carboplatin-etoposide combination in small cell lung cancer patients older than 70 years: a phase II trial.
SO - Lung Cancer 2002 Jan;35(1):1-7
AD - Service de Pneumologie, Centre Hospitalier Lyon Sud, 69495 Cedex, Pierre Benite, France.
BACKGROUND: No standard treatment is defined for elderly patients with small cell lung cancer (SCLC). Carboplatin and etoposide are highly active agents against SCLC. In this study, we evaluated the activity and toxicity of a combination of these two agents. PATIENTS AND METHODS: Thirty-four untreated patients with limited or extensive SCLC and median age of 73.9 years entered the study. Chemotherapy consisted of carboplatin i.v. on day 1 (AUC 5 using Calvert's formula) and etoposide 100 mg/m(2) given orally on days 1-5, every 4 weeks, and thoracic irradiation was given to limited disease patients after chemotherapy. RESULTS: The overall response rates was 59% (95% CI: 43-76). The median survival for all patients was 37 weeks (range 3-76 weeks). The toxicity was mainly haematological with grade 3-4 neutropenia in 59% of courses, febrile neutropenia in 15% of courses, and toxic death in 9% of patients. CONCLUSION: The results of this regimen are disappointing with worse response and survival, and more haematological toxicity than expected and previously reported, despite the use of Calvert's formula. Possible explanations are the use of etoposide per os rather than i.v., the frequent comorbidities of older patients and the inclusion of patients with poor prognosis factors.
UI - 11750707
AU - Tsurutani J; Komiya T; Uejima H; Tada H; Syunichi N; Oka M; Kohno S;
TI - Fukuoka M; Nakagawa K Mutational analysis of the beta-tubulin gene in lung cancer.
SO - Lung Cancer 2002 Jan;35(1):11-6
AD - Fourth Department of Internal Medicine, Kinki University School of Medicine, Ohonohigashi 377-2, Osakasayama, 589-8511, Osaka, Japan.
Recently, several studies have suggested that a major mechanism of resistance to paclitaxel might involve mutations in the beta-tubulin gene in tumor cells. To investigate the frequency of beta-tubulin mutations in Japanese patients with small and non-small cell lung cancer, direct sequence analysis following reverse transcription-polymerase chain reaction (RT-PCR) of the beta-tubulin gene was performed using total RNA from 20 lung cancer cell lines and 22 specimens from lung cancer patients. First-strand cDNA sequence analysis of the 42 samples showed silent mutations at codon 180 of the beta-tubulin gene, which encodes the GTP-binding site of the protein, and codons 195 and 217. However, neither missense nor non-sense mutations affecting microtubule dynamics, within or near the GTP-binding site of the beta-tubulin gene, were detected. These results indicate that beta-tubulin gene mutations might not play a major role in the mechanism of resistance to paclitaxel in Japanese lung cancer patients. Further investigations are needed to clarify the mechanism of drug resistance.
UI - 11750706
AU - Murray N
TI - Commentary on "carboplatin-etoposide association in small cell lung cancer patients older than 70 years: a phase II trial".
SO - Lung Cancer 2002 Jan;35(1):9-10
AD - British Columbia Cancer Agency, 600 West 10th Avenue, V5Z 4E6, Vancouver, BC, Canada.
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