PMID- 10786196
OWN - NLM
STAT- MEDLINE
DCOM- 20000512
LR  - 20171213
IS  - 0300-8916 (Print)
IS  - 0300-8916 (Linking)
VI  - 85
IP  - 6 Suppl 1
DP  - 1999 Nov-Dec
TI  - [Topotecan, a recent discovery and prospects for treating tumors of the lung].
PG  - S16-22
AB  - Topotecan is a new active drug in the treatment of lung cancer. In advanced non 
      small cell lung cancer (NSCLC) it showed 0-15% of objective response (OR) with 
      15% in the largest phase II study performed on 40 patients at the M.D. Anderson 
      Cancer Center. Interesting results have been reported in combination chemotherapy 
      with new drugs, in particular with gemcitabine. However, the role of topotecan in 
      NSCLC must be developed in further trials. Topotecan is one of the most active 
      drug in small cell lung cancer (SCLC). Particularly, it showed active in 
      sensitive pretreated patients with 14%-38% OR. In a phase III randomized trial 
      performed in pretreated patients, single agent topotecan showed similar OR and 
      survival but better palliative effect compared to the CAV regimen 
      (cyclophosphamide + adryamicin + vincristine). In first line chemotherapy 
      topotecan showed 39% OR as single agent. Interesting results have been showed in 
      combination chemotherapy in particular with taxol. Several studies are ongoing. 
      Topotecan as first line chemotherapy could be developed in old doublet 
      combinations (such as cisplatin or carboplatin + topotecan), new doublet 
      combinations (such as taxol or vinorelbine or gemcitabine + topotecan), triplet 
      chemotherapy combinations (such as cisplatin or carboplatin + taxol + topotecan) 
      and sequential or alternate chemotherapy regimens. Topotecan reaches high drug 
      concentration in the brain. It showed activity in brain metastases of SCLC with 
      40%-63% OR and 13%-43% of complete response in pretreated patients. This 
      particular activity could be considered in first line chemotherapy as prophylaxis 
      of brain metastases or to treat patients with brain metastases at diagnosis. Oral 
      topotecan is a very interesting drug. It showed 36% OR in outfit untreated SCLC 
      patients and 23% in pretreated patients, respectively. Oral formulation seems to 
      induce less toxicity when compared to the intravenous drug. In the future 
      topotecan should be developed as first line combined radio-chemotherapy treatment 
      to make the best of its radiosensitizer effect. The activity on brain metastases 
      also must be developed. Oral formulation is interesting because it is less toxic 
      and could be considered in less toxic regimens in particular in outfit or elderly 
      patients. However in the next years the role of topotecan will be better defined 
      performing phase III randomized trials.
FAU - Gridelli, C
AU  - Gridelli C
AD  - Divisione di Oncologia Medica B, Istituto Nazionale Tumori, Napoli.
LA  - ita
PT  - English Abstract
PT  - Journal Article
TT  - Topotecan, recenti acquisizioni e prospettive nel trattamento dei tumori del 
      polmone.
PL  - United States
TA  - Tumori
JT  - Tumori
JID - 0111356
RN  - 7M7YKX2N15 (Topotecan)
SB  - IM
MH  - Administration, Oral
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse 
      effects/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology
MH  - Cerebellar Neoplasms/drug therapy/secondary
MH  - Clinical Trials, Phase II as Topic
MH  - Clinical Trials, Phase III as Topic
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Randomized Controlled Trials as Topic
MH  - Topotecan/administration & dosage/adverse effects/*therapeutic use
EDAT- 2000/04/29 09:00
MHDA- 2000/05/20 09:00
CRDT- 2000/04/29 09:00
PHST- 2000/04/29 09:00 [pubmed]
PHST- 2000/05/20 09:00 [medline]
PHST- 2000/04/29 09:00 [entrez]
PST - ppublish
SO  - Tumori. 1999 Nov-Dec;85(6 Suppl 1):S16-22.