Experience with carboplatin and etoposide maintenance chemotherapy in patients with extensive stage small cell lung cancer
Amaan Siddiqi1, Huzefa Bahrain2, Michael Auerbach1,2
1Georgetown University School of Medicine, 2Auerbach Hematology and Oncology, Baltimore, MD, USA
Purpose: To determine whether maintenance therapy with carboplatin and etoposide improves progression-free and overall survival in patients with extensive stage small cell lung cancer, compared to the standard four to six cycles of cisplatin and etoposide.
Methods: Forty-two patient records (25 males and 17 females) were retrospectively reviewed in a single community practice. All patients were over the age of 18, with pathologically and radiographically proven extensive stage small cell lung carcinoma (SCLC). The starting doses of chemotherapy were carboplatin, AUC (area under the curve) of 6 IV day 1, and etoposide, 100 mg/m2 IV days 1–3. The regimen was administered every 3 weeks and increased to every 4 to 5 weeks as tolerated or until documented progression occurred. Varying second-line chemotherapies were used.
Results: Median overall survival was 17 months from diagnosis, with a progression-free survival of 15 months. Seventy-nine percent of the patients survived more than 10 months. The 1- and 2-year overall survival (OAS) rates were 0.74 (31 patients) and 0.31 (13 patients), respectively. The 1- and 2-year progression free survival (PFS) rates were 0.50 (21 patients) and 0.21 (9 patients), respectively.
Conclusion: The improved overall and progression-free survival compared to the current standard in this small single center cohort suggests that maintenance therapy with carboplatin and etoposide to progression may be a prudent area for further investigation in a properly powered randomized, controlled trial.
Keywords: progression-free survival, maintenance therapy, overall survival, metastasis
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF]