Difference between revisions of "Small cell lung cancer - historical"
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===References=== | ===References=== | ||
# Johnson DH, Bass D, Einhorn LH, Crawford J, Perez CA, Bartolucci A, Omura GA, Greco FA. Combination chemotherapy with or without thoracic radiotherapy in limited-stage small-cell lung cancer: a randomized trial of the Southeastern Cancer Study Group. J Clin Oncol. 1993 Jul;11(7):1223-9. [http://ascopubs.org/doi/abs/10.1200/JCO.1993.11.7.1223 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/8391064 PubMed] | # Johnson DH, Bass D, Einhorn LH, Crawford J, Perez CA, Bartolucci A, Omura GA, Greco FA. Combination chemotherapy with or without thoracic radiotherapy in limited-stage small-cell lung cancer: a randomized trial of the Southeastern Cancer Study Group. J Clin Oncol. 1993 Jul;11(7):1223-9. [http://ascopubs.org/doi/abs/10.1200/JCO.1993.11.7.1223 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/8391064 PubMed] | ||
+ | |||
+ | ==MACC {{#subobject:219cc3|Regimen=1}}== | ||
+ | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
+ | |- | ||
+ | |[[#top|back to top]] | ||
+ | |} | ||
+ | MACC: '''<u>M</u>'''ethotrexate, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>C</u>'''CNU (Lomustine) | ||
+ | ===Regimen {{#subobject:4ee088|Variant=1}}=== | ||
+ | {| class="wikitable" style="width: 100%; text-align:center;" | ||
+ | !style="width: 25%"|Study | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
+ | !style="width: 25%"|Comparator | ||
+ | !style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]] | ||
+ | |- | ||
+ | |[http://ascopubs.org/doi/abs/10.1200/JCO.1985.3.7.969 Maurer et al. 1985] | ||
+ | | style="background-color:#1a9851" |Phase III (C) | ||
+ | |CCV/AV | ||
+ | | style="background-color:#ffffbf" |Seems not superior | ||
+ | |- | ||
+ | |} | ||
+ | ====Chemotherapy==== | ||
+ | *[[Methotrexate (MTX)]] | ||
+ | *[[Doxorubicin (Adriamycin)]] | ||
+ | *[[Cyclophosphamide (Cytoxan)]] | ||
+ | *[[Lomustine (Ceenu)]] | ||
+ | |||
+ | ===References=== | ||
+ | # Maurer LH, Pajak T, Eaton W, Comis R, Chahinian P, Faulkner C, Silberfarb PM, Henderson E, Rege VB, Baldwin PE, Weiss R, Rafla S, Prager D, Carey R, Perry M, Choi NC. Combined modality therapy with radiotherapy, chemotherapy, and immunotherapy in limited small-cell carcinoma of the lung: a Phase III Cancer and Leukemia Group B Study. J Clin Oncol. 1985 Jul;3(7):969-76. [http://ascopubs.org/doi/abs/10.1200/JCO.1985.3.7.969 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/2991478 PubMed] | ||
==VMV-VAC {{#subobject:139cc3|Regimen=1}}== | ==VMV-VAC {{#subobject:139cc3|Regimen=1}}== |
Revision as of 16:16, 7 January 2019
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main SCLC page for current regimens.
31 regimens on this page
38 variants on this page
|
Limited stage, induction
CAV
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CAV: Cyclophosphamide, Adriamycin (Doxorubicin), Vincristine
Regimen
Study | Evidence |
---|---|
Johnson et al. 1993 | Non-randomized portion of RCT |
Chemotherapy
21-day cycle for 6 cycles
References
- Johnson DH, Bass D, Einhorn LH, Crawford J, Perez CA, Bartolucci A, Omura GA, Greco FA. Combination chemotherapy with or without thoracic radiotherapy in limited-stage small-cell lung cancer: a randomized trial of the Southeastern Cancer Study Group. J Clin Oncol. 1993 Jul;11(7):1223-9. link to original article PubMed
MACC
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MACC: Methotrexate, Adriamycin (Doxorubicin), Cyclophosphamide, CCNU (Lomustine)
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Maurer et al. 1985 | Phase III (C) | CCV/AV | Seems not superior |
Chemotherapy
References
- Maurer LH, Pajak T, Eaton W, Comis R, Chahinian P, Faulkner C, Silberfarb PM, Henderson E, Rege VB, Baldwin PE, Weiss R, Rafla S, Prager D, Carey R, Perry M, Choi NC. Combined modality therapy with radiotherapy, chemotherapy, and immunotherapy in limited small-cell carcinoma of the lung: a Phase III Cancer and Leukemia Group B Study. J Clin Oncol. 1985 Jul;3(7):969-76. link to original article PubMed
VMV-VAC
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VMV-VAC: Vincristine, Methotrexate, VP-16 (Etoposide), VP-16 (Etoposide), Adriamycin (Doxorubicin), Cyclophosphamide
Regimen
Study | Evidence |
---|---|
Kies et al. 1987 | Non-randomized portion of RCT |
Chemotherapy
- Vincristine (Oncovin)
- Methotrexate (MTX)
- Etoposide (Vepesid)
- Doxorubicin (Adriamycin)
- Cyclophosphamide (Cytoxan)
References
- Kies MS, Mira JG, Crowley JJ, Chen TT, Pazdur R, Grozea PN, Rivkin SE, Coltman CA Jr, Ward JH, Livingston RB. Multimodal therapy for limited small-cell lung cancer: a randomized study of induction combination chemotherapy with or without thoracic radiation in complete responders; and with wide-field versus reduced-field radiation in partial responders: a Southwest Oncology Group Study. J Clin Oncol. 1987 Apr;5(4):592-600. link to original article PubMed
Limited stage, definitive chemoradiotherapy
CC/DE & RT
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CC/DE & RT: Cyclophosphamide & Cisplatin alternating with Doxorubicin & Etoposide, with Radiation Therapy
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Arriagada et al. 1993 | Phase III (E) | Lower-dose CC/DE | Seems to have superior OS |
Chemoradiotherapy
- Cyclophosphamide (Cytoxan)
- Cisplatin (Platinol)
- Doxorubicin (Adriamycin)
- Etoposide (Vepesid)
- External beam radiotherapy
References
- Arriagada R, Le Chevalier T, Pignon JP, Rivière A, Monnet I, Chomy P, Tuchais C, Tarayre M, Ruffié P. Initial chemotherapeutic doses and survival in patients with limited small-cell lung cancer. N Engl J Med. 1993 Dec 16;329(25):1848-52. link to original article PubMed
CEV & RT
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CEV & RT: Cyclophosphamide, Epirubicin, Vincristine, Radiation Therapy
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Perry et al. 1987 (CALGB 8083) | Phase III (E) | 1. CEV | Superior OS |
2. CEV, then RT | Not reported | ||
Sundstrøm et al. 2002 | Phase III (C) | Cisplatin, Etoposide, RT | Inferior OS |
Chemoradiotherapy
Subsequent treatment
- Patients with CR: Prophylactic cranial irradiation
References
- CALGB 8083: Perry MC, Eaton WL, Propert KJ, Ware JH, Zimmer B, Chahinian AP, Skarin A, Carey RW, Kreisman H, Faulkner C, Comis R, Green MR. Chemotherapy with or without radiation therapy in limited small-cell carcinoma of the lung. N Engl J Med. 1987 Apr 9;316(15):912-8. link to original article PubMed
- Sundstrøm S, Bremnes RM, Kaasa S, Aasebø U, Hatlevoll R, Dahle R, Boye N, Wang M, Vigander T, Vilsvik J, Skovlund E, Hannisdal E, Aamdal S; Norwegian Lung Cancer Study Group. Cisplatin and etoposide regimen is superior to cyclophosphamide, epirubicin, and vincristine regimen in small-cell lung cancer: results from a randomized phase III trial with 5 years' follow-up. J Clin Oncol. 2002 Dec 15;20(24):4665-72. link to original article contains verified protocol PubMed
Methotrexate, RT, Cyclophosphamide
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Regimen
Study | Evidence |
---|---|
Thatcher et al. 1982 | Non-randomized portion of RCT |
Chemotherapy, part 1
Radiotherapy
Chemotherapy, part 2
References
- Thatcher N, Barber PV, Hunter RD, Carroll KB, Jegarajah S, Wilkinson PM, Crowther D. 11-week course of sequential methotrexate, thoracic irradiation, and moderate-dose cyclophosphamide for "limited"-stage small-cell bronchogenic carcinoma: a study from the Manchester Lung Tumour Group. Lancet. 1982 May 8;1(8280):1040-3. link to SD article PubMed
Extensive stage, induction
ACE
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ACE: Adriamycin (Doxorubicin), Cyclophosphamide, Etoposide
AVE: Adriamycin (Doxorubicin), Vepesid (Etoposide), Endoxan (Cyclophosphamide)
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Klastersky et al. 1985 | Phase II | ORR: 66% | |
Sculier et al. 1993 | Phase III (C) | Multi-drug regimen | Seems not superior |
Baka et al. 2008 | Phase III (C) | EP | Seems not superior |
Used as a comparator arm in older studies. The non-randomized results of Klastersky et al. 1985 established this regimen as a standard control.
Chemotherapy
References
- Klastersky J, Sculier JP, Dumont JP, Becquart D, Vandermoten G, Rocmans P, Michel J, Longeval E, Dalesio O. Combination chemotherapy with adriamycin, etoposide, and cyclophosphamide for small cell carcinoma of the lung: a study by the EORTC Lung Cancer Working Party (Belgium). Cancer. 1985 Jul 1;56(1):71-5. link to original article PubMed
- Sculier JP, Paesmans M, Bureau G, Dabouis G, Libert P, Vandermoten G, Van Cutsem O, Berchier MC, Ries F, Michel J, Sergysels R, Mommen P, Klastersky J. Multiple-drug weekly chemotherapy versus standard combination regimen in small-cell lung cancer: a phase III randomized study conducted by the European Lung Cancer Working Party. J Clin Oncol. 1993 Oct;11(10):1858-65. link to original article PubMed
- Baka S, Califano R, Ferraldeschi R, Aschroft L, Thatcher N, Taylor P, Faivre-Finn C, Blackhall F, Lorigan P. Phase III randomised trial of doxorubicin-based chemotherapy compared with platinum-based chemotherapy in small-cell lung cancer. Br J Cancer. 2008 Aug 5;99(3):442-7. link to original article link to PMC article contains protocol PubMed
BACO
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BACO: Bleomycin, Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine)
Regimen
Study | Evidence |
---|---|
Einhorn et al. 1976 | Non-randomized |
Chemotherapy
References
- Einhorn LH, Fee WH, Farber MO, Livingston RB, Gottlieb JA. Improved chemotherapy for small-cell undifferentiated lung cancer. JAMA. 1976 Mar 22;235(12):1225-9. link to original article PubMed
CAV
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CAV: Cyclophosphamide, Adriamycin (Doxorubicin), Vincristine
Variant #1, 1000/40/1, capped by BSA
Study | Evidence | Comparator | Efficacy | Toxicity |
---|---|---|---|---|
Johnson et al. 1987 | Phase III (C) | HDCAV | Seems not superior | Less toxic |
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 (maximum dose of 2000 mg) IV once on day 1
- Doxorubicin (Adriamycin) 40 mg/m2 (maximum dose of 80 mg) IV once on day 1
- Vincristine (Oncovin) 1 mg/m2 (maximum dose of 2 mg) IV once on day 1
21-day cycle for 6 cycles
Variant #2, 1000/50/1.4, uncapped vincristine
Study | Evidence | Comparator | Efficacy | Toxicity |
---|---|---|---|---|
Ettinger et al. 1990 | Phase III (C) | CAV/HEM | Inferior OS | |
Girling 1996 | Phase III (C) | Oral Etoposide | Seems to have superior OS | |
Ettinger et al. 2002 (ECOG E1588) | Phase III (C) | 1. Ifosfamide | Seems not superior | More toxic |
2. Teniposide | Seems not superior | More toxic |
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 IV once on day 1
21-day cycle for 4 to 6 cycles
Subsequent treatment
- ECOG E1588, CR: 2 more cycles of CAV, then PCI
- ECOG E1588, PR: CAV until progression of disease, then salvage EP
Variant #3, 1000/50/2, flat-dose vincristine
Study | Evidence | Comparator | Efficacy | Toxicity |
---|---|---|---|---|
Holoye et al. 1977 | Non-randomized | |||
Evans et al. 1987 | Phase III (C) | CAV/PE | Seems to have inferior OS | Similar toxicity |
Maksymiuk et al. 1994 | Non-randomized portion of RCT |
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Vincristine (Oncovin) 2 mg IV once on day 1
21-day cycle 6 cycles
References
- Holoye PY, Samuels ML, Lanzotti VJ, Smith T, Barkley HT Jr. Combination chemotherapy and radiation therapy for small cell carcinoma. JAMA. 1977 Mar 21;237(12):1221-4. link to original article PubMed
- Evans WK, Feld R, Murray N, Willan A, Coy P, Osoba D, Shepherd FA, Clark DA, Levitt M, MacDonald A, Wilson K, Shelley W, Pater J. Superiority of alternating non-cross-resistant chemotherapy in extensive small cell lung cancer: a multicenter, randomized clinical trial by the National Cancer Institute of Canada. Ann Intern Med. 1987 Oct;107(4):451-8. Erratum in: Ann Intern Med 1988 Mar;108(3):496. link to original article contains protocol PubMed
- Johnson DH, Einhorn LH, Birch R, Vollmer R, Perez C, Krauss S, Omura G, Greco FA. A randomized comparison of high-dose versus conventional-dose cyclophosphamide, doxorubicin, and vincristine for extensive-stage small-cell lung cancer: a phase III trial of the Southeastern Cancer Study Group. J Clin Oncol. 1987 Nov;5(11):1731-8. link to original article contains verified protocol PubMed
- Ettinger DS, Finkelstein DM, Abeloff MD, Ruckdeschel JC, Aisner SC, Eggleston JC. A randomized comparison of standard chemotherapy versus alternating chemotherapy and maintenance versus no maintenance therapy for extensive-stage small-cell lung cancer: a phase III study of the Eastern Cooperative Oncology Group. J Clin Oncol. 1990 Feb;8(2):230-40. link to original article PubMed
- Maksymiuk AW, Jett JR, Earle JD, Su JQ, Diegert FA, Mailliard JA, Kardinal CG, Krook JE, Veeder MH, Wiesenfeld M, Tschetter LK, Levitt R. Sequencing and schedule effects of cisplatin plus etoposide in small-cell lung cancer: results of a North Central Cancer Treatment Group randomized clinical trial. J Clin Oncol. 1994 Jan;12(1):70-6. link to original article PubMed
- Girling DJ; Medical Research Council Lung Cancer Working Party. Comparison of oral etoposide and standard intravenous multidrug chemotherapy for small-cell lung cancer: a stopped multicentre randomised trial. Lancet. 1996 Aug 31;348(9027):563-6. link to original article PubMed
- ECOG E1588: Ettinger DS, Finkelstein DM, Ritch PS, Lincoln ST, Blum RH; Eastern Cooperative Oncology Group. Study of either ifosfamide or teniposide compared to a standard chemotherapy for extensive disease small cell lung cancer: an Eastern Cooperative Oncology Group randomized study (E1588). Lung Cancer. 2002 Sep;37(3):311-8. link to original article contains verified protocol PubMed
CAV/PE
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CAV/PE: Cyclophosphamide, Adriamycin (Doxorubicin), Vincristine alternating with Platinol (Cisplatin) & Etoposide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Evans et al. 1987 | Phase III (E) | CAV | Seems to have superior OS |
Furuse et al. 1998 | Phase III (C) | CODE | Seems not superior |
Chemotherapy, CAV portion
Chemotherapy, PE portion
References
- Evans WK, Feld R, Murray N, Willan A, Coy P, Osoba D, Shepherd FA, Clark DA, Levitt M, MacDonald A, Wilson K, Shelley W, Pater J. Superiority of alternating non-cross-resistant chemotherapy in extensive small cell lung cancer: a multicenter, randomized clinical trial by the National Cancer Institute of Canada. Ann Intern Med. 1987 Oct;107(4):451-8. Erratum in: Ann Intern Med 1988 Mar;108(3):496. link to original article contains protocol PubMed
- Furuse K, Fukuoka M, Nishiwaki Y, Kurita Y, Watanabe K, Noda K, Ariyoshi Y, Tamura T, Saijo N; The Japan Clinical Oncology Group. Phase III study of intensive weekly chemotherapy with recombinant human granulocyte colony-stimulating factor versus standard chemotherapy in extensive-disease small-cell lung cancer. J Clin Oncol. 1998 Jun;16(6):2126-32. link to original article PubMed
CDE
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CDE: Cyclophosphamide, Doxorubicin, Etoposide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Postmus et al. 1996 | Phase III (C) | CDE/VIMP | Seems not superior |
Ardizzoni et al. 2002 (EORTC 08923) | Phase III (C) | Intensified CDE | Seems not superior |
de Jong et al. 2007 | Phase III (C) | CP | Seems not superior |
Chemotherapy
References
- Postmus PE, Scagliotti G, Groen HJ, Gozzelino F, Burghouts JT, Curran D, Sahmoud T, Kirkpatrick A, Giaccone G, Splinter TA. Standard versus alternating non-cross-resistant chemotherapy in extensive small cell lung cancer: an EORTC phase III trial. Eur J Cancer. 1996 Aug;32A(9):1498-503. link to original article PubMed
- EORTC 08923: Ardizzoni A, Tjan-Heijnen VC, Postmus PE, Buchholz E, Biesma B, Karnicka-Mlodkowska H, Dziadziuszko R, Burghouts J, Van Meerbeeck JP, Gans S, Legrand C, Debruyne C, Giaccone G, Manegold C; European Organization for Research and Treatment of Cancer-Lung Cancer Group. Standard versus intensified chemotherapy with granulocyte colony-stimulating factor support in small-cell lung cancer: a prospective European Organization for Research and Treatment of Cancer-Lung Cancer Group Phase III Trial-08923. J Clin Oncol. 2002 Oct 1;20(19):3947-55. link to original article PubMed
- de Jong WK, Groen HJ, Koolen MG, Biesma B, Willems LN, Kwa HB, van Bochove A, van Tinteren H, Smit EF. Phase III study of cyclophosphamide, doxorubicin, and etoposide compared with carboplatin and paclitaxel in patients with extensive disease small-cell lung cancer. Eur J Cancer. 2007 Nov;43(16):2345-50. Epub 2007 Sep 10. link to original article PubMed
CEV
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CEV: Cyclophosphamide, Epirubicin, Vincristine
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Sundstrøm et al. 2002 | Phase III (C) | Cisplatin & Etoposide | Seems not superior |
Chemotherapy
References
- Sundstrøm S, Bremnes RM, Kaasa S, Aasebø U, Hatlevoll R, Dahle R, Boye N, Wang M, Vigander T, Vilsvik J, Skovlund E, Hannisdal E, Aamdal S; Norwegian Lung Cancer Study Group. Cisplatin and etoposide regimen is superior to cyclophosphamide, epirubicin, and vincristine regimen in small-cell lung cancer: results from a randomized phase III trial with 5 years' follow-up. J Clin Oncol. 2002 Dec 15;20(24):4665-72. link to original article contains verified protocol PubMed
Cyclophosphamide, Lomustine, Methotrexate
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Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Cohen et al. 1979 | Phase III (C) | Chemotherapy & Thymosin fraction V | Seems to have inferior OS |
Chemotherapy
References
- Cohen MH, Chretien PB, Ihde DC, Fossieck BE Jr, Makuch R, Bunn PA Jr, Johnston AV, Shackney SE, Matthews MJ, Lipson SD, Kenady DE, Minna JD. Thymosin fraction V and intensive combination chemotherapy. Prolonging the survival of patients with small-cell lung cancer. JAMA. 1979 Apr 27;241(17):1813-5. link to original article PubMed
EVI
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EVI: Epirubicin, Vindesine, Ifosfamide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Sculier et al. 2001 | Phase III (C) | 1. Accelerated EVI & GM-CSF | Seems not superior |
2. Accelerated EVI & antibiotics | Seems not superior |
Not commonly used but was a comparator arm for at least one RCT; here for reference purposes only.
Chemotherapy
References
- Sculier JP, Paesmans M, Lecomte J, Van Cutsem O, Lafitte JJ, Berghmans T, Koumakis G, Florin MC, Thiriaux J, Michel J, Giner V, Berchier MC, Mommen P, Ninane V, Klastersky J; European Lung Cancer Working Party. A three-arm phase III randomised trial assessing, in patients with extensive-disease small-cell lung cancer, accelerated chemotherapy with support of haematological growth factor or oral antibiotics. Br J Cancer. 2001 Nov 16;85(10):1444-51. link to original article link to PMC article PubMed
ICE
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ICE: Ifosfamide, Carboplatin, Etoposide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Lorigan et al. 2005 | Phase III (C) | Dose-dense ICE | Seems not superior |
Chemotherapy
References
- Lorigan P, Woll PJ, O'Brien ME, Ashcroft LF, Sampson MR, Thatcher N. Randomized phase III trial of dose-dense chemotherapy supported by whole-blood hematopoietic progenitors in better-prognosis small-cell lung cancer. J Natl Cancer Inst. 2005 May 4;97(9):666-74. Erratum in: J Natl Cancer Inst. 2005 Jun 15;97(12):941. link to original article PubMed
PCDE
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PCDE: Platinol (Cisplatin), Cyclophosphamide, EpiDoxorubicin (Epirubicin), Etoposide
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Pujol et al. 1997 | Phase III (C) | High-dose PCDE | Superior OS |
Pujol et al. 2001 | Phase III (E) | EP | Superior OS |
Pujol et al. 2007 (FNCLCC cleo04 IFCT 00-01) | Phase III (C) | PCDE & Thalidomide | Seems not superior |
Chemotherapy
References
- Pujol JL, Douillard JY, Rivière A, Quoix E, Lagrange JL, Berthaud P, Bardonnet-Comte M, Polin V, Gautier V, Milleron B, Chomy F, Chomy P, Spaeth D, Le Chevalier T. Dose-intensity of a four-drug chemotherapy regimen with or without recombinant human granulocyte-macrophage colony-stimulating factor in extensive-stage small-cell lung cancer: a multicenter randomized phase III study. J Clin Oncol. 1997 May;15(5):2082-9. link to original article PubMed
- Pujol JL, Daurès JP, Rivière A, Quoix E, Westeel V, Quantin X, Breton JL, Lemarié E, Poudenx M, Milleron B, Moro D, Debieuvre D, Le Chevalier T. Etoposide plus cisplatin with or without the combination of 4'-epidoxorubicin plus cyclophosphamide in treatment of extensive small-cell lung cancer: a French Federation of Cancer Institutes multicenter phase III randomized study. J Natl Cancer Inst. 2001 Feb 21;93(4):300-8. link to original article PubMed
- FNCLCC cleo04 IFCT 00-01: Pujol JL, Breton JL, Gervais R, Tanguy ML, Quoix E, David P, Janicot H, Westeel V, Gameroff S, Genève J, Maraninchi D. Phase III double-blind, placebo-controlled study of thalidomide in extensive-disease small-cell lung cancer after response to chemotherapy: an intergroup study FNCLCC cleo04 IFCT 00-01. J Clin Oncol. 2007 Sep 1;25(25):3945-51. link to original article PubMed
TEC
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TEC: Taxol (Paclitaxel) Etoposide), Carboplatin
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Reck et al. 2003 | Phase III (E) | CEV | Seems to have superior OS |
Chemotherapy
References
- Reck M, von Pawel J, Macha HN, Kaukel E, Deppermann KM, Bonnet R, Ulm K, Hessler S, Gatzemeier U. Randomized phase III trial of paclitaxel, etoposide, and carboplatin versus carboplatin, etoposide, and vincristine in patients with small-cell lung cancer. J Natl Cancer Inst. 2003 Aug 6;95(15):1118-27. link to original article PubMed
VIP
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VIP: Vepesid (Etoposide), Ifosfamide, Platinol (Cisplatin)
Regimen
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
Loehrer et al. 1995 | Phase III (E) | Cisplatin & Etoposide | Seems to have superior OS |
Chemotherapy
- Etoposide (Vepesid) 75 mg/m2 IV once per day on days 1 to 4
- Ifosfamide (Ifex) 1200 mg/m2 IV once per day on days 1 to 4
- Cisplatin (Platinol) 20 mg/m2 IV once per day on days 1 to 4
21-day cycle for 4 cycles
References
- Loehrer PJ Sr, Ansari R, Gonin R, Monaco F, Fisher W, Sandler A, Einhorn LH. Cisplatin plus etoposide with and without ifosfamide in extensive small-cell lung cancer: a Hoosier Oncology Group study. J Clin Oncol. 1995 Oct;13(10):2594-9. link to original article contains verified protocol PubMed
Relapsed or refractory disease
CAV
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CAV: Cyclophosphamide, Adriamycin (Doxorubicin), Vincristine
Variant #1
Study | Evidence | Comparator | Efficacy |
---|---|---|---|
von Pawel et al. 1999 | Phase III (C) | Topotecan | Seems not superior |
von Pawel et al. 1999 does not clearly state the duration of each cycle, but 21 days is used in other CAV regimens, and there was no information in the paper that contradicted this.
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 (maximum dose of 2000 mg) (route not specified) once on day 1
- Doxorubicin (Adriamycin) 45 mg/m2 (maximum dose of 100 mg) IV once on day 1
- Vincristine (Oncovin) 2 mg IV once on day 1
Supportive medications
- G-CSF use per physician discretion
21-day cycles, given until progression of disease, unacceptable toxicity, or 6 cycles beyond maximal response
Patients with stable disease after 4 cycles could have treatment discontinued at physician discretion.
Variant #2
Study | Evidence |
---|---|
Ihde et al. 1994 | Non-randomized portion of RCT |
Treatment given after progression on standard-dose EP versus high-dose EP. Ihde et al. 1994 did not specifically say that the three medications were all given on day 1, but this is assumed to be the case based on other CAV regimens.
Chemotherapy
- Cyclophosphamide (Cytoxan) 1000 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 45 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (maximum dose of 2 mg) IV once on day 1
21-day cycle for 4 cycles
References
- Ihde DC, Mulshine JL, Kramer BS, Steinberg SM, Linnoila RI, Gazdar AF, Edison M, Phelps RM, Lesar M, Phares JC, Grayson J, Minna JD, Johnson BE. Prospective randomized comparison of high-dose and standard-dose etoposide and cisplatin chemotherapy in patients with extensive-stage small-cell lung cancer. J Clin Oncol. 1994 Oct;12(10):2022-34. link to original article contains verified protocol PubMed
- von Pawel J, Schiller JH, Shepherd FA, Fields SZ, Kleisbauer JP, Chrysson NG, Stewart DJ, Clark PI, Palmer MC, Depierre A, Carmichael J, Krebs JB, Ross G, Lane SR, Gralla R. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol. 1999 Feb;17(2):658-67. link to original article contains verified protocol PubMed
CDE
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CDE: Cyclophosphamide, Doxorubicin, Etoposide
Regimen
Study | Evidence |
---|---|
Postmus et al. 1987 | Phase II |
Chemotherapy
References
- Postmus PE, Berendsen HH, van Zandwijk N, Splinter TA, Burghouts JT, Bakker W. Retreatment with the induction regimen in small cell lung cancer relapsing after an initial response to short term chemotherapy. Eur J Cancer Clin Oncol. 1987 Sep;23(9):1409-11. PubMed