Chemotherapy small cell

Topotecan hydrochloride is a DNA topoisomerase inhibitor. Topotecan hydrochloride is an antitumor drug with topoisomerase I-inhibitory activity. It is indicated in metastatic carcinoma of the ovary after failure of initial or subsequent chemotherapy small-cell-lung-cancer-sensitive disease after failure of first-line chemotherapy. 

Erlotinib (Tarceva ) competes with ATP in the HER1/EGFR ATP-binding pocket. It is used in the clinic in locally advanced or metastatic non-small cell lung cancer after failure of at least one chemotherapy regime [1, 3, 5]. 

Chemo, chemotherapy NSCLC, non-small cell lung cancer PORT, postoperative radiotherapy TNM, tumor node metastasis. 

Small cell lung cancer typically presents as extensive disease (approximately 60% to 70% of new cases) and progresses very quickly. Small cell carcinomas are very responsive to chemotherapy and radiation. Radiotherapy became the standard in 1969, when a randomized trial showed that it offered the potential for cure, whereas surgery did not.20 For the vast majority of patients, chemotherapy with or without radiotherapy is the treatment of choice. Even after a complete response to therapy, the cancer usually recurs within 6 to 8 months, and survival time following recurrence is typically short ( 4 months). This yields a typical survival rate of 14 to 20 months for limited disease and 8 to 13 months for extensive disease.33 Table 87-6 illustrates the general treatment path of SCLC. 

Arriagada R, Bergman B, Dunant A, et al. Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. New Engl J Med 2004 350(4) 351—360. 

Radiation therapy is the treatment of choice for chemotherapy-resistant tumors such as non-small cell lung cancer (NSCLC) or in chemotherapy-refractory patients with SVCS. Between 70% and 90% of patients will experience relief of symptoms. Radiation therapy also may be combined with chemotherapy for chemotherapy-sensitive tumors such as SCLC and lymphoma. In the rare emergency situations of airway obstruction or elevated intracranial pressure, empirical radiotherapy prior to tissue diagnosis should be used. In most patients, symptoms resolve within 1 to 3 weeks. 

Hanna, N. et al.. Randomized phase IE trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy, /. Clin. Oncol, 22,... 

Shepherd, F.A. et al., A randomized placebo-controlled trial of erlotinib in patients with advanced non-small cell lung cancer (NSCLC) following failure of 1st line or 2nd line chemotherapy. A National Cancer Institute of Canada Clinical Trials Croup (NCIC CTC) trial, Proc. Am. Soc. Clin. Oncol., 22(SuppL), 14S, Abstr. 7022, 2004. 

Crawford J, Ozer H, Stoller R et al. Reduction by granuloc34e colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. N EnglJMed 1991 325 164 170. 

Schuler M, Herrmann R, De Greve JL, et al. Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer results of a multicenter phase II study. J Clin Oncol 2001 19(6) 1750-1758. 

Bonomi P. Treatment of stage III non-small cell lung cancer with thoracic radiation therapy and simultaneous platinum chemotherapy. Semin Oncol 1994 21(Suppl 6) 101-108. 

Robinow JS, Shaw EG, Eagan RT, etal. Results of combination chemotherapy and thoracic irradiation therapy for unresectable non-small cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 1989 17 1203-1210. 

Weiden PL, Piantodosi S. Preoperative chemotherapy cisplatin and fluorouracil and radiation therapy in stage III non-small cell lung cancer A phase II study of the Lung Cancer Study Group. JNatl Cancer Oust 1991 83 266-272. 

Strauss GM, Herndon JE, Sherman DD, et al. Neoadjuvant chemotherapy and radiotherapy followed by surgery in stage Ilia non-small cell carcinoma of the lung report of a Cancer and Leukemia Group B phase II study. J Clin Oncol 1992 10 1237-1244. 

Schiller JH, Harrington D, Sandler A, et al. A Randomized Phase III Trial of Four Chemotherapy Regimens in Advanced Non-Small Cell Lung Cancer (NSCLC) (abstract 2). 2000. Pro Am Soc Clin Oncol 19 1a. 

Vokes EE, Leopold KA, Herndon JE, et al. CALGB Study 9431 Arandomized phase study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy and concomitant chemoradiotherapy for unresectable stage III non-small cell lung cancer. Lung Cancer 2000 29(Sl) 49(Abstract 158). 

Perez-Soler R, Fossella FV, Glisson BS, et al. Phase II study of topotecan in patients with advanced non-small-cell lung cancer previously untreated with chemotherapy. J Clin Oncol 1996 14(2) 503-513. 

Fossella FV, Zinner RG, Komaki R, et al. Gemcitabine with concurrent chest radiation followed by consolidation chemotherapy with gemcitabine plus cisplatin A phase I trial for patients with stage III non-small cell lung cancer. Lung Cancer 2000 29(Suppl 1) 111 (abstract 368). 

Socinski M. The current status of adjuvant chemotherapy for resected non-small cell lung cancer. Semin Oncol 1999 26(Suppl 15) 34—39. 

Niiranen A, Niitamo-Korhonen S, Kouri M, et al. Adjuvant chemotherapy after radical surgery for non-small-cell lung cancer. A randomized study J Clin Oncol 1992 10 1927-1932. 

Wada H, Hitomi S, Teramatsu T. Adjuvant chemotherapy after complete resection in non-small-cell lung cancer. J Clin Oncol 1996 14 1048-1054. 

Lad T, Wagner H, Piantadosi S. Randomized Phase II evaluation of preoperative chemotherapy alone and radiotherapy alone in stage Ilia non-small cell lung cancer. (Abstract) Proc Amer Soc Clin Oncol 1991 10 258. 

RosellR, Gomez-Codina J, Camps C, et al. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small cell lung cancer. N Eng J Med 1994 330 153-158. 

Splinter TAW, va Schil PE, Kramer GWPM, et al. Randomized trial of surgery versus radiotherapy in patients with stage IIIA (N2) non-small cell lung cancer after a response to induction chemotherapy. EORTC 08941. Clinical Lung Cancer 2000 2 69-72. 

Faber LP, Kittle CF, Warren WH, et al. Properative chemotherapy and irradiation for stage in non-small cell lung cancer. Ann ThorSurg 1989 47 669-675. 

Eberhardt W, Wilke H, Stamatis G, et al. Preoperative chemotherapy followed by concurrent chemoradiation therapy based on hyperfractionated accelerated radiotherapy and definitive surgery in locally advanced non-small cell lung cancer. Mature results of a phase II trial. J Clin Oncol 1998 16 622-634. 

Chemotherapy in non-small cell lung cancer a meta-analysis using updated data on individual patients from 52 randomized clinical trials. Non-small Cell Lung Cancer Collaborative Group. BMJ 1995 311 899-909. 

Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in resectable non-small cell lung cancer First analysis of a randomized trial in 353 patients. JNatl Cancer Inst 1991 83 417-423. 

WagnerH, AntoniaS, Shaw G, et al. Induction Chemotherapy with Carboplatin and Paclitaxel followed by Hyperfractionated Accelerated Radiation for Patients with Unresectable Stage IIA and IIB Non-Small-Cell Lung Cancer. Proc Am Soc Clin Oncol 1998 17 469a (abstr). 

Pritchard RS, Anthony SP. Chemotherapy plus radiotherapy compared with radiotherapy alone in the treatment of locally advanced, unresectable, non-small cell lung cancer A meta-analysis. Ann Intern Med 1996 125 723-729. 

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