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Clinical studies with etoposide phosphate

F A Greco1, J D Hainsworth

  • 1Sarah Cannon-Minnie Pearl Cancer Center, Centennial Medical Center, Nashville, TN 37203, USA.

Seminars in Oncology
|December 1, 1996
PubMed
Summary
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Etoposide phosphate demonstrates equivalent efficacy and toxicity to etoposide in small cell lung cancer treatment. This novel formulation offers easier administration and potentially lower costs for clinical use.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Etoposide phosphate (Etopophos) is a prodrug of etoposide.
  • Clinical studies were conducted to evaluate its safety, efficacy, and pharmacokinetics.

Purpose of the Study:

  • To determine the maximum tolerated dose (MTD) and pharmacokinetics of etoposide phosphate.
  • To compare the efficacy and toxicity of etoposide phosphate plus cisplatin versus etoposide plus cisplatin in small cell lung cancer (SCLC).

Main Methods:

  • Phase I trial to establish MTD and pharmacokinetics.
  • Phase II randomized trial comparing etoposide phosphate plus cisplatin with etoposide plus cisplatin in SCLC patients.
  • Studies on low-dose continuous infusion and high-dose etoposide phosphate with G-CSF.

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Main Results:

  • MTD of etoposide phosphate was 100 mg/m2/d for 5 days; myelosuppression was the dose-limiting toxicity.
  • Etoposide phosphate rapidly converted to etoposide in vivo.
  • Phase II trial showed equivalent response rates and toxicity between etoposide phosphate and etoposide regimens in SCLC.
  • No significant survival difference was observed between the treatment arms.

Conclusions:

  • Etoposide phosphate is therapeutically equivalent to etoposide in SCLC treatment.
  • Etoposide phosphate offers advantages in ease of administration and potentially lower overall costs.
  • Etoposide phosphate is a preferable alternative to etoposide for routine clinical application.