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HAMBURG, Germany-“The overall results of the treatment of advanced non–small-cell lung cancer are unsatisfactory,” Ulrich Gatzemeier, MD, said in an overview of recent German trials he presented at the 9th World Conference on Lung Cancer. Dr. Gatzemeier is head of the Department of Thoracic Oncology with Hospital Grosshansdorf, Hamburg, Germany.

HERAKLION, Greece-A multicenter phase III study comparing the triple combination of paclitaxel (Taxol), cisplatin (Platinol), and etoposide (VePesid) to the double combination of cisplatin and etoposide as front-line treatment for small-cell lung cancer was stopped because of eight toxic deaths. Less than a third of the planned number of patients had been accrued.

MADISON, Wisconsin-Although topotecan (Hycamtin) has clear activity in small-cell lung cancer, the optimal combinations, schedule, and route of administration for use of this topoisomerase-I inhibitor as first-line therapy are yet to be determined, according to Joan H. Schiller, MD, of the University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin.

TOKYO, Japan-“I remain convinced that irinotecan is one of the most active agents for the treatment of lung cancer, both non–small-cell and small-cell,” stated David H. Johnson, MD, professor of medicine and director of medical oncology at Vanderbilt University Medical Center, Nashville. Dr. Johnson was leadoff speaker at a seminar titled ‘‘Current Status of Irinotecan in Lung Cancer’’ held in conjunction with the 9th World Conference on Lung Cancer. The meeting was supported by an educational grant from Pharmacia Oncology, Yakult Honsha Co., Ltd., Daiichi Pharmaceutical Co., Ltd., and Aventis Pharma S.A.

ROCHESTER, Minnesota-The combination of irinotecan (Camptosar)and docetaxel (Taxotere) is a promising treatment for recurrent non–small-cell lung cancer (NSCLC), but the dosing schedule tested in phase I and II trials needs to be modified to reduce the potential for myelosuppression and diarrhea, cautioned Alex Adjei, MD, of the Mayo Clinic in Rochester, Minnesota.

NASHVILLE, Tennessee-Conceding that treatment of advanced non–small-cell lung cancer (NSCLC) has made only limited progress in the past decade, members of the Eastern Cooperative Oncology Group (ECOG) have vowed to pursue newer chemotherapeutic agents aggressively. ECOG’s focus has changed, according to David H. Johnson, MD, director of hematology and oncology with the Vanderbilt-Ingram Cancer Center, Nashville. Investigators now see the promise in new biological agents with novel mechanisms of action that might be integrated into current chemotherapeutic regimens.

AMSTERDAM, The Netherlands-Cisplatin (Platinol), the cornerstone of chemotherapy for advanced non–small-cell lung cancer (NSCLC), continues to come under increased scrutiny, noted Pieter E. Postmus, MD, FCCP. Investigators are searching for chemotherapeutic strategies that are as effective as platinum-based therapy, but are better tolerated and more cost-effective, he explained. Dr. Postmus is with the Department of Pulmonology, Vrije Universiteit, University Hospital, in Amsterdam, The Netherlands.

MONTPELLIER, France-A four-drug regimen produced better outcomes in patients with extensive small-cell lung cancer than the commonly used combination of etoposide (VePesid) and cisplatin (Platinol), a French multicenter study showed.

OSAKA, Japan-A randomized phase III trial in small-cell lung cancer patients with extensive disease was stopped after interim analyses uncovered a clear survival benefit for a regimen combining irinotecan (Camptosar) and cisplatin (Platinol) over an etoposide (VePesid) and cisplatin combination.

CHARLESTON, South Carolina-A phase II trial involving the sequential administration of docetaxel (Taxotere), gemcitabine (Gemzar), and irinotecan (Camptosar) in patients with non–small-small cell lung cancer (NSCLC) is being planned. Announcement of the new trial comes in the wake of results of a phase I trial among patients with solid tumors that was reported at the 9th World Conference on Lung Cancer by Caio Max S. Rocha Lima, MD, assistant professor of medicine at the Medical University of South Carolina in Charleston.

NEW HAVEN, Connecticut-The combination of irinotecan (Camptosar) and a taxane is well tolerated in dose-finding studies and deserves further evaluation in non–small-cell lung cancer, according to Randy S. Rich, MD, of Yale University School of Medicine.

TOKYO-Weekly paclitaxel (Tax-ol) and carboplatin (Paraplatin) is an effective and well-tolerated second-line therapy in patients with non-small-cell lung cancer (NSCLC) who failed first-line therapy with the same agents, Mark A. Socinski, MD, said at the 9th World Conference on Lung Cancer. Dr. Socinski is director of the Multidisciplinary Thoracic Oncology Program, University of North Carolina, Chapel Hill.

BETHESDA, Md-The National Cancer Institute has launched a randomized, 3,000-person study to determine the feasibility of doing a larger scale trial to test whether spiral CT screening improves lung cancer survival. Six centers began recruiting volunteers in early September and hope to enroll 500 subjects each by the end of October.

NASHVILLE, Tennessee-Irinotecan (Camptosar) combined with radiation therapy is active in non–small-cell lung cancer (NSCLC) and is most effective when the chemotherapy and radiation therapy are given concurrently, Hak Choy, MD, reported at a clinical investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology. Dr. Choy is Professor and Vice Chairman of the Department of Radiation Oncology at the Vanderbilt Cancer Center in Nashville, Tennessee.

OSAKA, Japan-Irinotecan/cisplatin combination therapy improved survival compared to etoposide/cisplatin in extensive-stage small-cell lung cancer (SCLC), Masahiro Fukuoka, MD, reported at an investigators’ workshop sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology. Two-year survival in the Japan Clinical Oncology Group (JCOG)-9511 study was 19% with irinotecan/cisplatin vs 9% with etoposide/cisplatin, according to Dr. Fukuoka, who is professor of the 4th Department of Internal Medicine at Kinki University School of Medicine in Osaka, Japan.

WASHINGTON-The use of spiral CT scanning to screen for early lung cancers poses scientific, economic, and policy issues that the oncology community, advocacy groups, insurers, and government health agencies need to address quickly, an expert panel said at a day-long conference on reducing lung cancer mortality. The conference was sponsored by the Cancer Research Foundation of America and the Roy Castle Lung Cancer Foundation, Liverpool, England.