Bolus versus infusion regimens of etoposide and cisplatin in treatment of non-small cell lung cancer: A study of the north central cancer treatment group

Richard M. Goldberg, James R. Jett, Terry M Therneau, P. Steven Johnson, Loren K. Tschetter, James E. Krook, Michael H. Veeder, David Owen, Paul S. Etzell, Dale F. Andres

Research output: Contribution to journalArticle

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Abstract

In an effort to test clinically the hypothesis that the duration of cellular exposure to etoposide (VP-16) and cisplatin (CDDP) is an important determinant of cytotoxicity, we performed a phase III randomized trial comparing an outpatient bolus regimen of combined VP-16 and CDDP with a sequential infusion over 72 hours of these same two drugs. All patients had stage IV non-small cell lung cancer, and survival was the primary end point. Of 113 patients randomly allocated to the ! study, 108 were assessable for response, survival, and toxicity. A major response was observed in 20 (37%) of 54 patients on the bolus regimen and in 16 (30%) of 54 patients receiving infusion therapy. The median time to progression was 61 and 88 days for bolus and infusion therapy, respectively. The median survival time was 148 and 157 days, respectively (P = .71). Study results were not consistent with the possibility that infusion therapy could be associated with a 50% improvement in median survival, ie, from 5 months to 71/2 months. Toxicity was primarily myelosuppression and was significantly greater with the infusion regimen. We conclude that infusion therapy as tested in this protocol with VP-16 and CDDP does not offer any advantage in response rate, time to disease progression, or survival as compared with bolus therapy. In addition, infusion : therapy is associated with a greater degree of neutropenia and ' more treatment-related deaths.

Original languageEnglish (US)
Pages (from-to)1899-1903
Number of pages5
JournalJournal of the National Cancer Institute
Volume82
Issue number24
StatePublished - Dec 19 1990

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Cisplatin
Oncology
Lung Cancer
Etoposide
Non-Small Cell Lung Carcinoma
Therapy
Toxicity
Cancer
Cells
Cell
Cytotoxicity
Survival
Neoplasms
Progression
Therapeutics
Randomized Trial
Survival Time
End point
Lung cancer
Neutropenia

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Radiology Nuclear Medicine and imaging

Cite this

Bolus versus infusion regimens of etoposide and cisplatin in treatment of non-small cell lung cancer : A study of the north central cancer treatment group. / Goldberg, Richard M.; Jett, James R.; Therneau, Terry M; Johnson, P. Steven; Tschetter, Loren K.; Krook, James E.; Veeder, Michael H.; Owen, David; Etzell, Paul S.; Andres, Dale F.

In: Journal of the National Cancer Institute, Vol. 82, No. 24, 19.12.1990, p. 1899-1903.

Research output: Contribution to journalArticle

Goldberg, RM, Jett, JR, Therneau, TM, Johnson, PS, Tschetter, LK, Krook, JE, Veeder, MH, Owen, D, Etzell, PS & Andres, DF 1990, 'Bolus versus infusion regimens of etoposide and cisplatin in treatment of non-small cell lung cancer: A study of the north central cancer treatment group', Journal of the National Cancer Institute, vol. 82, no. 24, pp. 1899-1903.
Goldberg, Richard M. ; Jett, James R. ; Therneau, Terry M ; Johnson, P. Steven ; Tschetter, Loren K. ; Krook, James E. ; Veeder, Michael H. ; Owen, David ; Etzell, Paul S. ; Andres, Dale F. / Bolus versus infusion regimens of etoposide and cisplatin in treatment of non-small cell lung cancer : A study of the north central cancer treatment group. In: Journal of the National Cancer Institute. 1990 ; Vol. 82, No. 24. pp. 1899-1903.
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