Retrospective analysis to compare the efficacy of oral (O) vs. intravenous (IV) etoposide given in combination with carboplatin for small cell lung cancer (SCLC), extensive disease (ED).

Authors

Anders Mellemgaard

Anders Mellemgaard

Department of Oncology, Herlev Hospital, Herlev, Denmark

Anders Mellemgaard , Ditte Stampe Hersby , Farruhk Naheed Chaudhary , Seppo W. Langer

Organizations

Department of Oncology, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital, Copenhagen, Denmark, Herlev University Hospital, Copenhagen, Denmark, Rigshospitalet, Copenhagen, Denmark

Research Funding

Other

Background: Approximately two thirds of patients diagnosed with SCLC will have ED at the time of diagnosis. Response rates to chemotherapy are high but median overall survival for patients treated with chemotherapy is only 9 to 10 months. Patients with ED SCLC considered fit for chemotherapy is normally treated with combination chemotherapy including cisplatin or carboplatin, and etoposide or irinotecan. The usual dosing scheme is 3 weeks intervals with the platin administered on day 1 and etoposide given day 1-3 or 1-5. Etoposide is available in as well intravenous as oral formulations. Concerns about the incomplete and variable bioavailability of oral etoposide have been raised. A randomized study of cisplatin with either oral or IV etoposide found no significant difference in treatment outcome but increased rate of severe or life-threatening hematologic toxicity. Methods: The two cancer hospitals serving the Copenhagen area are using carboplatin + etoposide for palliative treatment of SCLC ED. While carboplatin is used identically (AUC5, IV d1), etoposide is given IV by HUH (120mg/m2, IV d1-3) and orally by CUH (200mg/m2 O, d1-3). From the hospital patient database, we identified patients with SCLC, ED treated in 2011-2013. Route of etoposide administration, dose reductions and GCSF use was noted. PFS and OS was calculated from hospital records. Results: 200 SCLC, ED patients received treatment (116 at HUH, 84 at CUH). A non-significant higher proportion of women were treated at HUH while median age was identical. PFS was longer at HUH than CUH (195 vs 140 days), but the OS was identical (235 vs 227 days). Conclusions: The two dosing schemes: O and IV yield similar OS, but longer PFS with the IV schedule. The survival seen is in line with results from randomized trials although the present study includes all patients irrespectible of PS or comorbidity. We have no information on adverse events, quality of life or rates of hospitalization.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Lung Cancer-Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Small Cell Lung Cancer

Citation

J Clin Oncol 35, 2017 (suppl; abstr e20020)

DOI

10.1200/JCO.2017.35.15_suppl.e20020

Abstract #

e20020

Abstract Disclosures