F. Anthony Greco, MD

The preponderance of data support the accuracy of molecular assay diagnoses in about 80% to 90% of patients with known advanced primary cancers and in patients with cancer of unknown primary origin.

Despite nearly a decade of paclitaxel’scommercial availability,the best strategy formanaging several paclitaxel-relatedtoxicities including myalgia/arthralgiaremains to be elucidated. Mostavailable data in the treatment of myalgia/arthralgia have been anecdotal,reported in the form of case studiesor within the toxicity results of publishedpaclitaxel-containing clinicaltrials. Garrison et al have provided awell-written review summarizingwhat is currently known about theincidence and management of thisquality-of-life–impacting toxicity.

Dr. Kelly has provided a complete, well-written review of the current status and evolving role of irinotecan (CPT-11, Camptosar) as a cytotoxic agent for patients with non-small-cell lung cancer (NSCLC). Her review clearly demonstrates the value of irinotecan in this patient population and further supports the continued development of this agent in concert with other chemotherapeutic agents, biologically targeted agents, surgery, and/or radiotherapy.

Patients with limited-stage small-cell carcinoma of the lung are treated with combined-modality therapy with the intent to cure. Standard therapy consists of platinum-based combination chemotherapy, thoracic irradiation, and

The purpose of this study was to evaluate the combination of gemcitabine (Gemzar), paclitaxel (Taxol), and carboplatin (Paraplatin) in patients with advanced non–small-cell lung cancer (NSCLC). Previously untreated

Cancer of unknown primary site represents approximately 3% to 5% of all new cancer diagnoses. Adenocarcinomas account for 60% of all unknown primary cancers and poorly differentiated carcinomas or

In an attempt to further improve the quality of life and prognosis of patients with non–small-cell lung cancer, several clinical strategies exist to evaluate newer chemotherapy agents for this disease. Several of these

This comprehensive, well-written review of small-cell lung cancer by Drs. Clark and Ihde covers nearly all of the important clinical issues. However, a few areas warrant additional comment and discussion.

The past 20 years has seen an increasing trend toward the use of oral chemotherapy for the treatment of patients with a variety of malignancies. The advantages of oral chemotherapy include lower treatment cost, compared with that of intravenous (IV) administration, and more convenient treatment for patients.

We report here the preliminary results of a large phase II multicenter study done in the community setting, using paclitaxel (Taxol) (given by 1-hour infusion) plus carboplatin (Paraplatin) to treat patients with advanced non-small-cell lung cancer (NSCLC). In this study, 155 chemotherapy-naive patients with stage IIIB, stage IV, or recurrent metastatic non-small-cell lung cancer received the two drugs in 21-day cycles. Paclitaxel 225 mg/m² was given by 1-hour intravenous infusion followed immediately by carboplatin at a targeted area under the concentration-time curve of 6.0 (calculated according to the Calvert formula). Colony-stimulating factors were not used routinely. Objective responses occurred in 53 of 155 patients (34%) (53 of 144 [36%] evaluable patients) including three complete responses and 50 partial responses. Fifty-two other patients had stable disease at initial reevaluation. The median survival among all 155 patients was 8 months; the 1-year survival rate was 42%, and the 2-year survival rate was 20%. Leukopenia and cumulative peripheral neuropathy occurred consistently but rarely were severe or affected the course of therapy. One patient died due to sepsis. Other grade 3 and grade 4 toxicities were uncommon. This paclitaxel-carboplatin combination chemotherapy appears to be a relatively convenient, safe, and active regimen in advanced non-small-cell lung cancer.[ONCOLOGY 12(Suppl 2):71-73, 1998]

The management of patients with non-small-cell lung cancer (NSCLC) is still evolving. Newer third-generation chemotherapy (paclitaxel [Taxol]-based; vinorelbine [Navelbine]/cisplatin [Platinol]) is more effective than