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The role of oral etoposide in non-small cell lung cancer
R L Comis1, D M Friedland, B C Good
1Clinical Trials Research Center, MCP Hahnemann University, Philadelphia, Pennsylvania 19146, USA.
Abstract:
Oral etoposide has been tested alone and in combination in a number of tumour types since the late 1980s because of its mild toxicity, high response rates, ease of administration, and comparatively low cost. Encouraging early results with protracted oral etoposide therapy in small cell lung cancer have not been borne out in non-small cell lung cancer (NSCLC), particularly in the advanced-disease setting. However, in stage IV NSCLC, oral etoposide does appear to be as compatible with most of the newer agents as it has been with platinum compounds; these combinations continue to be explored, although they have not penetrated into standard usage. In stage III NSCLC, large combined-modality studies are ongoing. Other investigations examining protracted administration in combination with radiation 'sensitisers' are planned. It is possible that by exploiting the 'radiosensitising effect' of prolonged low dose oral etoposide, combined with that of other proven radiosensitisers such as paclitaxel, gemcitabine, and topotecan, we may identify a niche for oral etoposide in the future.
Insights
Oral etoposide shows promise in advanced non-small cell lung cancer (NSCLC) when combined with newer agents. Further research into its radiosensitizing effects may reveal future therapeutic niches.
Area of Science:
- Oncology
- Pharmacology
Background:
- Oral etoposide has been evaluated since the late 1980s for its favorable toxicity profile, efficacy, and administration ease.
- Early positive results in small cell lung cancer (SCLC) contrasted with less success in non-small cell lung cancer (NSCLC).
Purpose of the Study:
- To explore the potential of oral etoposide in various stages and combinations for non-small cell lung cancer treatment.
- To investigate the radiosensitizing properties of protracted oral etoposide administration.
Main Methods:
- Review of studies involving oral etoposide alone and in combination therapies.
- Ongoing clinical trials in stage III NSCLC and planned investigations with radiation sensitizers.
Main Results:
- Oral etoposide has shown compatibility with newer agents in stage IV NSCLC, though not yet standard practice.
- Combinations with platinum compounds have been explored.
- Large combined-modality studies are underway for stage III NSCLC.
Conclusions:
- Oral etoposide's role in advanced NSCLC is still under investigation, particularly in combination therapies.
- Exploiting its radiosensitizing effect with other agents may establish a future niche for oral etoposide in NSCLC treatment.
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