Lung Cancer

Topoisomerase I inhibitors have demonstrated significant activity in non-small-cell lung cancer. In phase II studies, particularly in Japan, single-agent irinotecan (Camptosar, CPT-11) has produced response rates as high

TOKYO-A platinum-based regimen including the investigational antifolate pemetrexed disodium (Alimta) is active and well tolerated in stage IIIb/IV non-small cell lung cancer (NSCLC), according to the final results of a phase II trial conducted by the National Cancer Institute of Canada Clinical Trials Group and presented at the 9th World Conference on Lung Cancer. The drug may also represent a new option for patients with mesothelioma.

The National Cancer Institute (NCI) is recruiting 3,000 current and former smokers for its Lung Screening Study, a year-long study of spiral computed tomography (CT) scans for lung cancer screening. Although the study will not determine if the

HAMBURG, Germany-GLOB-1 trial results, reported at the 25th Congress of the European Society of Medical Oncology (ESMO), have confirmed the combination of vinorelbine (Navelbine) and cisplatin (Platinol) as a chemotherapy reference standard in metastatic non-small-cell lung cancer (NSCLC), raising questions about the role of three-drug combinations in this setting.

TOKYO-A regimen of paclitaxel (Taxol) and vinorelbine (Navelbine) in non-small-cell lung cancer (NSCLC) appears to yield results similar to those with platinum-based regimens, according to phase I/II studies presented at the 9th World Conference on Lung Cancer.

TOKYO-Neoadjuvant therapy with the taxane docetaxel (Taxotere) is well tolerated and boosts survival over local treatment alone in patients with radically treatable, locally advanced non-small-cell lung cancer (NSCLC), investigators reported at the Ninth World Conference on Lung Cancer.

The fastest growing segment of the US population is the group over the age of 65 years. In the next 30 years, this group will comprise over 20% of the population. Because 60% of all cancers occur in this age group, there will be an expected rise in the total cancer burden.

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

OSAKA, Japan-Patients with stage IV non–small-cell lung cancer randomized to a regimen of cisplatin (Platinol) and irinotecan (Camptosar) survived significantly longer than those receiving a cisplatin/vindesine combination in a phase III trial conducted in Japan.

OSAKA, Japan-An overall response rate of 66% was achieved with a combination of irinotecan (Camptosar) and etoposide (VePesid) in patients with advanced small-cell lung cancer in a phase II study performed by the West Japan Thoracic Oncology Group. A final report on the study, conducted from 1995-98, was presented by Shinzoh Kudoh, MD, of Osaka City University School of Medicine.

BARCELONA, Spain-In a phase I study, 70% of small-cell lung cancer patients with extensive disease had objective responses when given carbo-platin (Paraplatin) and epirubicin (Ellence) in combination.

NAGASAKI, Japan-The combination of irinotecan (Camptosar) 40 mg/m² and cisplatin (Platinol) 60 mg/m² with concurrent thoracic radiotherapy should be tested for its potential role in treating patients with limited-stage small-cell lung cancer (SCLC).The recommendation was made at the conclusion of a phase I trial that evaluated the combination of irinotecan and cisplatin in three dose schedules in patients with histologically or cytologically proven limited-stage SCLC who had not undergone prior therapy for their disease.

NEW ORLEANS-Positron emission tomography (PET) scanning is a powerful predictor of survival in patients with non-small-cell lung cancer (NSCLC), reported Michael MacManus, MD, of the Peter MacCallum Cancer Institute, East Melbourne, Australia.

HAMBURG, Germany-“The overall results of the treatment of advanced non–small-cell lung cancer are unsatisfactory,” Ulrich Gatzemeier, MD, said in an overview of recent German trials he presented at the 9th World Conference on Lung Cancer. Dr. Gatzemeier is head of the Department of Thoracic Oncology with Hospital Grosshansdorf, Hamburg, Germany.

TOKYO, Japan-New phase III trial data suggest that irinotecan is one of the most active agents available to treat extensive-disease small-cell lung cancer, outperforming the standard etoposide (VePesid)/cisplatin (Platinol) treatment, while causing less myelosuppression.

HERAKLION, Greece-A multicenter phase III study comparing the triple combination of paclitaxel (Taxol), cisplatin (Platinol), and etoposide (VePesid) to the double combination of cisplatin and etoposide as front-line treatment for small-cell lung cancer was stopped because of eight toxic deaths. Less than a third of the planned number of patients had been accrued.

MADISON, Wisconsin-Although topotecan (Hycamtin) has clear activity in small-cell lung cancer, the optimal combinations, schedule, and route of administration for use of this topoisomerase-I inhibitor as first-line therapy are yet to be determined, according to Joan H. Schiller, MD, of the University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin.

TOKYO, Japan-“I remain convinced that irinotecan is one of the most active agents for the treatment of lung cancer, both non–small-cell and small-cell,” stated David H. Johnson, MD, professor of medicine and director of medical oncology at Vanderbilt University Medical Center, Nashville. Dr. Johnson was leadoff speaker at a seminar titled ‘‘Current Status of Irinotecan in Lung Cancer’’ held in conjunction with the 9th World Conference on Lung Cancer. The meeting was supported by an educational grant from Pharmacia Oncology, Yakult Honsha Co., Ltd., Daiichi Pharmaceutical Co., Ltd., and Aventis Pharma S.A.

Weekly dosing of the chemotherapy agent docetaxel (Taxotere) is active and well tolerated in elderly patients with advanced non–small-cell lung cancer (NSCLC), according to the results of a phase II study published in a recent issue of Cancer (89[2]:328-333, 2000).

ROCHESTER, Minnesota-The combination of irinotecan (Camptosar)and docetaxel (Taxotere) is a promising treatment for recurrent non–small-cell lung cancer (NSCLC), but the dosing schedule tested in phase I and II trials needs to be modified to reduce the potential for myelosuppression and diarrhea, cautioned Alex Adjei, MD, of the Mayo Clinic in Rochester, Minnesota.

NASHVILLE, Tennessee-Conceding that treatment of advanced non–small-cell lung cancer (NSCLC) has made only limited progress in the past decade, members of the Eastern Cooperative Oncology Group (ECOG) have vowed to pursue newer chemotherapeutic agents aggressively. ECOG’s focus has changed, according to David H. Johnson, MD, director of hematology and oncology with the Vanderbilt-Ingram Cancer Center, Nashville. Investigators now see the promise in new biological agents with novel mechanisms of action that might be integrated into current chemotherapeutic regimens.

AMSTERDAM, The Netherlands-Cisplatin (Platinol), the cornerstone of chemotherapy for advanced non–small-cell lung cancer (NSCLC), continues to come under increased scrutiny, noted Pieter E. Postmus, MD, FCCP. Investigators are searching for chemotherapeutic strategies that are as effective as platinum-based therapy, but are better tolerated and more cost-effective, he explained. Dr. Postmus is with the Department of Pulmonology, Vrije Universiteit, University Hospital, in Amsterdam, The Netherlands.

The aim of this pilot study was to assess the safety of the angiogenesis inhibitor thalidomide (Thalomid) given in combination with standard chemotherapy to patients with advanced non–small-cell lung cancer. Patients with unresectable stage IIIA, IIIB,

CHIBA, Japan-Combining either irinotecan (Camptosar) or vindesine with cis-platin (Platinol) produced similar objective responses and survival rates in patients with stage IIIB or IV non–small-cell lung cancer, according to final results of a randomized trial.

MONTPELLIER, France-A four-drug regimen produced better outcomes in patients with extensive small-cell lung cancer than the commonly used combination of etoposide (VePesid) and cisplatin (Platinol), a French multicenter study showed.

TOKYO, JAPAN-The administration of irinotecan (Camptosar) 60 mg/m² and cisplatin (Platinol) 80 mg/m² with concurrent thoracic radiotherapy has been identified as the recommended dose for evaluation in a phase II study in patients with locally advanced non–small-cell lung cancer (NSCLC).

OSAKA, Japan-A randomized phase III trial in small-cell lung cancer patients with extensive disease was stopped after interim analyses uncovered a clear survival benefit for a regimen combining irinotecan (Camptosar) and cisplatin (Platinol) over an etoposide (VePesid) and cisplatin combination.

CHARLESTON, South Carolina-A phase II trial involving the sequential administration of docetaxel (Taxotere), gemcitabine (Gemzar), and irinotecan (Camptosar) in patients with non–small-small cell lung cancer (NSCLC) is being planned. Announcement of the new trial comes in the wake of results of a phase I trial among patients with solid tumors that was reported at the 9th World Conference on Lung Cancer by Caio Max S. Rocha Lima, MD, assistant professor of medicine at the Medical University of South Carolina in Charleston.

NEW HAVEN, Connecticut-The combination of irinotecan (Camptosar) and a taxane is well tolerated in dose-finding studies and deserves further evaluation in non–small-cell lung cancer, according to Randy S. Rich, MD, of Yale University School of Medicine.

EAST LANSING, Michigan-A profile for elderly lung cancer patients at high risk of having major cancer-related losses in physical functioning has emerged from a Michigan State University study.