The current role and future prospects of paclitaxel in the treatment of small cell lung cancer.

When combination regimens containing a platinum compound and etoposide are used, median survivals in patients with extensive- and limited-stage small cell lung cancer are 7 to 10 months and 15 to 20 months, respectively. A recent randomized trial demonstrated equivalent efficacy and decreased toxicity with carboplatin/etoposide compared with cisplatin/etoposide. Because of excellent single-agent activity, paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has been recently added to various platinum/etoposide combinations. Phase I/II studies with paclitaxel/cisplatin/etoposide and paclitaxel/carboplatin/etoposide have demonstrated excellent activity with acceptable toxicity. Ongoing phase III trials will better define the contribution of paclitaxel to standard platinum/etoposide regimens. In addition, phase II trials of novel paclitaxel combinations (e.g., paclitaxel/topotecan, paclitaxel/carboplatin/topotecan) are ongoing.