Feasibility of oral topotecan plus intravenous paclitaxel in advanced non-small-cell lung cancer

Standard chemotherapy regimens in non-small-cell lung cancer (NSCLC) are platinum-based (cisplatin, carboplatin), with inherent, well-known antitumor activity and toxicity. However, the availability of new agents with novel mechanisms of action and activity in a range of tumor types, coupled with suboptimal activity of single-agent therapy, have prompted the investigation of multidrug regimens in the treatment of NSCLC. One potential combination regimen, in which each agent has antitumor activity in NSCLC monotherapy, is topotecan plus paclitaxel. This article will review the feasibility and tolerability of an oral formulation of topotecan (1.0-1.5 mg/m(2)/day x 5 days) administered with intravenous paclitaxel (175 mg/m(2) as a 3-hour infusion on day 1) in advanced NSCLC patients. The maximum tolerated dose of oral topotecan will be reported, along with preliminary response and tolerability data.