Topotecan: Incorporating It Into the Treatment of Solid Tumors

This issue of The Oncologist provides the reader with two useful reviews of the new chemotherapeutic agent topotecan, one of a class of topoisomerase I inhibitors that is being studied and incorporated into the treatment of various malignancies. Topotecan was approved for the treatment of refractory ovarian cancer in 1996, and has shown promising activity against a variety of solid tumors, as well as hematologic malignancies. One paper discusses clinical guidelines for managing topotecan-related hematologic toxicities, and centers on data derived from ovarian cancer studies. The other focuses on the role of topotecan in the treatment of small cell lung cancer (SCLC), where it has consistently shown encouraging results and for which definitive trials are now being conducted. As front-line therapy for ovarian cancer and small cell lung cancer is dominated by platinum-based regimens, the dosing guidelines and management issues discussed are pertinent for both tumor types.