Cisplatin plus etoposide in small cell lung cancer.

Bronchogenic carcinoma is the leading cause of cancer related death in the United States. Approximately 20% to 25% of patients will present with small cell lung cancer (SCLC). The median survival time of patients treated with supportive care alone is about 2 to 4 months. Despite this grim prognosis, chemotherapy, with or without radiotherapy, has impacted upon the survival of patients with SCLC. Combination chemotherapy with agents such as cyclophosphamide, vincristine, and doxorubicin has routinely produced response rates of 60% to 80%. Subsequently, the median survival of treated patients has been lengthened to 10 to 14 months, with apparent cures in approximately 10% of patients with limited-stage disease. To improve these results, investigators have tried various treatment strategies, including evaluation of preclinical models of synergy, clinical trials with newer agents, and theoretic and practical considerations of dosing and scheduling. Recently, two groups of compounds, the epipodophyllotoxins and the platinum compounds have demonstrated single-agent activity in SCLC. This paper highlights the developmental role of two of these agents, cisplatin and etoposide, in this disease.