Lung Cancer

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OSAKA, Japan-An overall response rate of 66% was achieved with a combination of irinotecan (Camptosar) and etoposide (VePesid) in patients with advanced small-cell lung cancer in a phase II study performed by the West Japan Thoracic Oncology Group. A final report on the study, conducted from 1995-98, was presented by Shinzoh Kudoh, MD, of Osaka City University School of Medicine.

NAGASAKI, Japan-The combination of irinotecan (Camptosar) 40 mg/m² and cisplatin (Platinol) 60 mg/m² with concurrent thoracic radiotherapy should be tested for its potential role in treating patients with limited-stage small-cell lung cancer (SCLC).The recommendation was made at the conclusion of a phase I trial that evaluated the combination of irinotecan and cisplatin in three dose schedules in patients with histologically or cytologically proven limited-stage SCLC who had not undergone prior therapy for their disease.

NEW ORLEANS-Positron emission tomography (PET) scanning is a powerful predictor of survival in patients with non-small-cell lung cancer (NSCLC), reported Michael MacManus, MD, of the Peter MacCallum Cancer Institute, East Melbourne, Australia.

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.