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Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases
OBJECTIVES: Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7–8 months in pa...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427968/ https://www.ncbi.nlm.nih.gov/pubmed/25903963 http://dx.doi.org/10.1186/s12967-015-0491-3 |
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author | Boni, Corrado Pagano, Maria Baldi, Licia Gnoni, Roberta Braglia, Luca Savoldi, Luisa Zanelli, Francesca |
author_facet | Boni, Corrado Pagano, Maria Baldi, Licia Gnoni, Roberta Braglia, Luca Savoldi, Luisa Zanelli, Francesca |
author_sort | Boni, Corrado |
collection | PubMed |
description | OBJECTIVES: Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7–8 months in patients with extended disease (ED). In 1995, a randomized trial of the Hoosier Group in 171 ED patients showed a significant advantage in overall survival in patients treated with PEI (Cisplatin, Etoposide and Ifosfamide), compared to PE. Despite that, PEI regimen has not become a commonly used regimen in SCLC. MATERIALS AND METHODS: Here we present a retrospective analysis of 46 consecutive patients (30 males and 16 females) with SCLC that were treated at our Institution with PEI regimen: Cisplatin 20 mg/m2, Etoposide 75 mg/m2 and Ifosfamide 1200 mg/m2, day 1 to 4, every 3 weeks. Patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. Median age was 63 (range 59–70); performance status (PS) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%). RESULTS: In 19 limited disease (LD) patients partial response (PR) rate was 74%, and complete response (CR) was 16%. In 27 ED patients we observed 63% of PR and 26% of CR. Median time to progression (TTP) was 15.2 months in LD and 7.1 months in ED with median overall survival (OS) of 28.2 and 11.8 months, respectively. Toxicity was manageable, with a high dose intensity. CONCLUSIONS: PEI regimen, in our opinion, may be a possible therapeutic option, with high activity and an acceptable toxicity profile. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02324296. INSTITUTIONAL REVIEW BOARD THAT APPROVED THE STUDY: Institutional review board of Reggio Emilia, Azienda Ospedaliera S.Maria Nuova/IRCCS. |
format | Online Article Text |
id | pubmed-4427968 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44279682015-05-13 Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases Boni, Corrado Pagano, Maria Baldi, Licia Gnoni, Roberta Braglia, Luca Savoldi, Luisa Zanelli, Francesca J Transl Med Protocol OBJECTIVES: Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7–8 months in patients with extended disease (ED). In 1995, a randomized trial of the Hoosier Group in 171 ED patients showed a significant advantage in overall survival in patients treated with PEI (Cisplatin, Etoposide and Ifosfamide), compared to PE. Despite that, PEI regimen has not become a commonly used regimen in SCLC. MATERIALS AND METHODS: Here we present a retrospective analysis of 46 consecutive patients (30 males and 16 females) with SCLC that were treated at our Institution with PEI regimen: Cisplatin 20 mg/m2, Etoposide 75 mg/m2 and Ifosfamide 1200 mg/m2, day 1 to 4, every 3 weeks. Patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. Median age was 63 (range 59–70); performance status (PS) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%). RESULTS: In 19 limited disease (LD) patients partial response (PR) rate was 74%, and complete response (CR) was 16%. In 27 ED patients we observed 63% of PR and 26% of CR. Median time to progression (TTP) was 15.2 months in LD and 7.1 months in ED with median overall survival (OS) of 28.2 and 11.8 months, respectively. Toxicity was manageable, with a high dose intensity. CONCLUSIONS: PEI regimen, in our opinion, may be a possible therapeutic option, with high activity and an acceptable toxicity profile. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02324296. INSTITUTIONAL REVIEW BOARD THAT APPROVED THE STUDY: Institutional review board of Reggio Emilia, Azienda Ospedaliera S.Maria Nuova/IRCCS. BioMed Central 2015-04-24 /pmc/articles/PMC4427968/ /pubmed/25903963 http://dx.doi.org/10.1186/s12967-015-0491-3 Text en © Boni et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Protocol Boni, Corrado Pagano, Maria Baldi, Licia Gnoni, Roberta Braglia, Luca Savoldi, Luisa Zanelli, Francesca Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title | Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title_full | Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title_fullStr | Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title_full_unstemmed | Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title_short | Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases |
title_sort | pei regimen: a therapeutic option in small cell lung cancer? a retrospective monoinstitutional analysis of 46 consecutive cases |
topic | Protocol |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427968/ https://www.ncbi.nlm.nih.gov/pubmed/25903963 http://dx.doi.org/10.1186/s12967-015-0491-3 |
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