Pei regimen: a therapeutic option in small cell lung cancer? A retrospective monoinstitutional analysis of 46 consecutive cases.

Abstract

OBJECTIVES:

Combination chemotherapy is very active in small cell lung cancer (SCLC), although no improvement in overall survival (OS) has been done in the last 25 years, with Cisplatin-Etoposide (PE) still considered the world-wide standard, with an average median survival of about 7-8 months in patients with extended disease (ED). In 1995, a randomized trial of the Hoosier Group in 171 ED patients showed a significant advantage in overall survival in patients treated with PEI (Cisplatin, Etoposide and Ifosfamide), compared to PE. Despite that, PEI regimen has not become a commonly used regimen in SCLC.

MATERIALS AND METHODS:

Here we present a retrospective analysis of 46 consecutive patients (30 males and 16 females) with SCLC that were treated at our Institution with PEI regimen: Cisplatin 20 mg/m2, Etoposide 75 mg/m2 and Ifosfamide 1200 mg/m2, day 1 to 4, every 3 weeks. Patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. Median age was 63 (range 59-70); performance status (PS) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%).

RESULTS:

In 19 limited disease (LD) patients partial response (PR) rate was 74%, and complete response (CR) was 16%. In 27 ED patients we observed 63% of PR and 26% of CR. Median time to progression (TTP) was 15.2 months in LD and 7.1 months in ED with median overall survival (OS) of 28.2 and 11.8 months, respectively. Toxicity was manageable, with a high dose intensity.

CONCLUSIONS:

PEI regimen, in our opinion, may be a possible therapeutic option, with high activity and an acceptable toxicity profile.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT02324296 .

INSTITUTIONAL REVIEW BOARD THAT APPROVED THE STUDY:

Institutional review board of Reggio Emilia, Azienda Ospedaliera S.Maria Nuova/IRCCS.

• Authors: Corrado Boni, Maria Pagano, Licia Baldi, Roberta Gnoni, Luca Braglia, Luisa Savoldi, Francesca Zanelli
• Journal: Journal of translational medicine (J Transl Med) Vol. 13 Pg. 130 (Apr 24 2015) ISSN: 1479-5876 [Electronic] England
• PMID: 25903963 (Publication Type: Journal Article, Observational Study)

Chemical References

• Etoposide
• Cisplatin
• Ifosfamide

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cisplatin (administration & dosage)
• Disease Progression
• Etoposide (administration & dosage)
• Female
• Humans
• Ifosfamide (administration & dosage)
• Lung Neoplasms (drug therapy)
• Male
• Middle Aged
• Retrospective Studies
• Small Cell Lung Carcinoma (drug therapy)
• Treatment Outcome