DeVore R, Hainsworth J, Greco F A, Hande K, Johnson D
Department of Medicine, West Virginia University School of Medicine, Morgantown.
Semin Oncol. 1992 Dec;19(6 Suppl 14):28-35.
Etoposide is used commonly to treat both small cell lung cancer and non-small cell lung cancer. It is usually administered intravenously over 3 to 5 consecutive days, and usually given in combination with cisplatin. Preclinical cellular and clinical pharmacokinetic studies have demonstrated that etoposide is schedule-dependent and is optimally administered at low doses over prolonged periods of time. Recent early phase clinical trials have demonstrated that oral etoposide can be administered safely for 14 to 21 consecutive days. This schedule has demonstrated outstanding activity in patients with both recurrent and previously untreated small cell lung cancer. Activity against non-small cell lung cancer has also been reported; response rates are similar to those seen with the most active single agents used in the treatment of the disease. Chronic oral etoposide also has the advantages of outpatient convenience and tolerable side effects. This overview discusses the role of chronic oral etoposide in the management of small cell lung cancer and non-small cell lung cancer. The scientific rationale, results of early phase clinical trials, ongoing research, and future directions regarding the chronic administration of this important antineoplastic drug are also reviewed.
依托泊苷常用于治疗小细胞肺癌和非小细胞肺癌。通常连续3至5天静脉给药，且通常与顺铂联合使用。临床前细胞和临床药代动力学研究表明，依托泊苷具有给药方案依赖性，最佳给药方式是长时间低剂量给药。近期的早期临床试验表明，口服依托泊苷可连续安全给药14至21天。该给药方案在复发性和初治小细胞肺癌患者中均显示出显著活性。也有针对非小细胞肺癌的活性报道；缓解率与用于治疗该疾病的最有效单药相似。长期口服依托泊苷还具有门诊治疗方便和副作用可耐受的优点。本综述讨论了长期口服依托泊苷在小细胞肺癌和非小细胞肺癌治疗中的作用。还综述了关于这种重要抗肿瘤药物长期给药的科学依据、早期临床试验结果、正在进行的研究以及未来方向。
