Title: Maintenance Oral Etoposide Following First Line Cisplatin-Etoposide Chemotherapy in Locally Advanced and Metastatic Non-Small Cell Lung Cancer Patients
Authors: Dr G. Raja, Dr K. Kalaichelvi
Background: Lung cancer is the most common cancer worldwide. Platinum based chemotherapy improved the overall survival up to 8-10 months and 1 year survival rate of 33%. Over the past years attention was focused on the possible effect of prolongation of therapy immediately after first line therapy, the so called Maintenance therapy.
Objective: The main objective of this study is to assess the response rate, safety and toxicity profile of oral Etoposide as maintenance therapy in advanced stage Non-Small Cell Lung Cancer (NSCLC).
Methods and Materials: Stage III/IV NSCLC patients who received 4-6 cycles of platinum based chemotherapy and achieved complete (CR), partial (PR) or stable (SD) response were included in the study. The patients were given oral Etoposide 50mg once daily for 14 days repeated every 21 days and evaluated with Chest X-ray, blood counts, biochemistry.
Results: Among the 40 patients who received platinum doublet, 32 patients received maintenance therapy. The mean number of cycles received was 7.5 (ranges from 1 to 27 cycles). Twenty one patients (65.6%) received more than or equal to six cycles. Three patients (9.3%) showed complete response, 4 (12.5%) had partial response and 15 (46.8%) were in the stable disease. Overall response rate was 21.8% and the Disease Control Rate was 68.7%. All patients had grade 1 or 2 toxicity only. The median progression free survival was 5 months.
Conclusion: Oral Etoposide maintenance therapy following Cisplatin based chemotherapy in advanced NSCLC was well tolerated & shows good disease control with less toxicity.
Keywords: Non-Small Cell Lung Cancer, Cisplatin, Etoposide, Maintenance, Progression free survival.