Small cell lung cancer (SCLC) is different and distinct from other lung cancers, called non–small-cell lung cancers (NSCLCs), because SCLC exhibits aggressive behavior, with rapid growth, early spread to distant sites, exquisite sensitivity to chemotherapy and radiation, and frequent association with distinct paraneoplastic syndromes. NCI (PDQ) recommends: 1.Combination chemotherapy with or without PCI given to patients with complete responses: •EP or EC: etoposide plus cisplatin or carboplatin.Other regimens that appear to produce similar survival outcomes but have been studied less extensively or are in less common use include:
•CAE/CDE: cyclophosphamide plus doxorubicin plus etoposide.
•ICE: ifosfamide plus cisplatin plus etoposide.
•Cisplatin plus irinotecan.
•Cyclophosphamide plus doxorubicin plus etoposide plus vincristine.
•CEV: cyclophosphamide plus etoposide plus vincristine.
In section SCL-B, NCCN lists a number of agents for "subsequent" chemotherapy. I undrstand it to include therapy for relapse as well as a quasi-maintenace approach ( maintenance itself is not yet standard in small edell lung cancer). Among them is docetaxel. The 1994 reference that it cites, by SMyth et al, is for a three weekly schedule. This paper reports a phase II trial in patients with previously-treated small cell carcinoma of the lung. 34 patients received 100 mg/m2 of docetaxel in an intravenous infusion given over 1 h every 21 days. Seven partial responses were reported (25% of 28 evaluable patients). Duration of response was 3.5-12.6 months.
A weekly schedule is equivalent to thrice-weekly, as shown by a pashe II study, albeit in non-small cell lung cancer. Weekly docetaxel 35 mg/m2 demonstrated similar efficacy and better tolerability than standard 3-weekly docetaxel 75 mg/m2 . There was aslo a study by Hainsworth et al in the elderly patietns with small cell lung cancer that found that weekly administration of docetaxel was found to reduce myelosuppression and other nonhematologic toxicities when compared with administration every 3 weeks.
http://www.nccn.org/professionals/physician_gls/PDF/sclc.pdf(2011 )
C Gridelli1et al ,Published online 3 January 2001
Carboplatin plus paclitaxel in extensive small cell lung cancer: a multicentre phase 2 studyBritish Journal of Cancer (2001) 84, 38–41
Wolfgang Schuette et al, Phase III Study of Second-Line Chemotherapy for Advanced Non–Small-Cell Lung Cancer With Weekly Compared With 3-Weekly Docetaxel Journal of Clinical Oncology, Vol 23, No 33 (November 20), 2005: pp. 8389-8395
J D Hainsworth, H A Burris, S Litchy, L H Morrissey, J H Barton, J E Bradof, F A Greco Weekly docetaxel in the treatment of elderly patients with advanced nonsmall cell lung carcinoma. A Minnie Pearl Cancer Research Network Phase II Trial.
Cancer (2000) Volume: 89, Issue: 2, Pages: 328-333
Small cell lung cancer (SCLC) is different and distinct from other lung cancers, called non–small-cell lung cancers (NSCLCs), because SCLC exhibits aggressive behavior, with rapid growth, early spread to distant sites, exquisite sensitivity to chemotherapy and radiation, and frequent association with distinct paraneoplastic syndromes. NCI (PDQ) recommends: 1.Combination chemotherapy with or without PCI given to patients with complete responses: •EP or EC: etoposide plus cisplatin or carboplatin.Other regimens that appear to produce similar survival outcomes but have been studied less extensively or are in less common use include:
•CAE/CDE: cyclophosphamide plus doxorubicin plus etoposide.
•ICE: ifosfamide plus cisplatin plus etoposide.
•Cisplatin plus irinotecan.
•Cyclophosphamide plus doxorubicin plus etoposide plus vincristine.
•CEV: cyclophosphamide plus etoposide plus vincristine.
In section SCL-B, NCCN lists a number of agents for "subsequent" chemotherapy. I undrstand it to include therapy for relapse as well as a quasi-maintenace approach ( maintenance itself is not yet standard in small edell lung cancer). Among them is docetaxel. The 1994 reference that it cites, by SMyth et al, is for a three weekly schedule. This paper reports a phase II trial in patients with previously-treated small cell carcinoma of the lung. 34 patients received 100 mg/m2 of docetaxel in an intravenous infusion given over 1 h every 21 days. Seven partial responses were reported (25% of 28 evaluable patients). Duration of response was 3.5-12.6 months.
A weekly schedule is equivalent to thrice-weekly, as shown by a pashe II study, albeit in non-small cell lung cancer. Weekly docetaxel 35 mg/m2 demonstrated similar efficacy and better tolerability than standard 3-weekly docetaxel 75 mg/m2 . There was aslo a study by Hainsworth et al in the elderly patietns with small cell lung cancer that found that weekly administration of docetaxel was found to reduce myelosuppression and other nonhematologic toxicities when compared with administration every 3 weeks.
http://www.nccn.org/professionals/physician_gls/PDF/sclc.pdf(2011 )
C Gridelli1et al ,Published online 3 January 2001
Carboplatin plus paclitaxel in extensive small cell lung cancer: a multicentre phase 2 studyBritish Journal of Cancer (2001) 84, 38–41
Wolfgang Schuette et al, Phase III Study of Second-Line Chemotherapy for Advanced Non–Small-Cell Lung Cancer With Weekly Compared With 3-Weekly Docetaxel Journal of Clinical Oncology, Vol 23, No 33 (November 20), 2005: pp. 8389-8395
J D Hainsworth, H A Burris, S Litchy, L H Morrissey, J H Barton, J E Bradof, F A Greco Weekly docetaxel in the treatment of elderly patients with advanced nonsmall cell lung carcinoma. A Minnie Pearl Cancer Research Network Phase II Trial.
Cancer (2000) Volume: 89, Issue: 2, Pages: 328-333