A randomized trial of amifostine as a cytoprotective agent in patients receiving chemotherapy for small cell lung cancer

• Published in: British journal of cancer Vol. 84; no. 1; pp. 19 - 24
• Main Authors: JOHNSON, P. W. M, MUERS, M. F, PEAKE, M. D, POULTER, K. M, GURNEY, E. M, NAPP, V, HEPBURN, P. M, BROWN, J. M
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 05-01-2001
• Subjects: Adult; Aged; Amifostine - therapeutic use; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biological and medical sciences; Carboplatin - administration & dosage; Carboplatin - adverse effects; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - mortality; Chemotherapy; Drug Administration Schedule; Etoposide - administration & dosage; Etoposide - adverse effects; Female; Humans; Ifosfamide - administration & dosage; Ifosfamide - adverse effects; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Male; Medical sciences; Middle Aged; Neutropenia - chemically induced; Neutropenia - prevention & control; Pharmacology. Drug treatments; Regular; Survival Analysis; Thrombocytopenia - chemically induced; Thrombocytopenia - prevention & control; Antineoplastic agent; Toxicity; Hemopathy; Bronchopulmonary; Randomization; Isomerases; Bronchus disease; Complication; Clinical trial; Antimitotic; Small cell carcinoma; Neutropenia; Platinum II Complexes; Human; Thrombocytopenia; Lung disease; DNA topoisomerase (ATP-hydrolysing); Drug combination; Leukopenia; Respiratory disease; Enzyme; Ifosfamide; Etoposide; Enzyme inhibitor; Malignant tumor; Amifostine; Podophyllotoxine derivatives; Alkylating agent; Chemotherapy; Oxazaphosphinane derivatives; Platelet; Treatment; Cytoprotector; Nitrogen mustard; Carboplatin
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1054/bjoc.2000.1539

A randomized trial was conducted to determine whether administration of Amifostine with chemotherapy for small cell lung cancer could decrease the toxicity. 84 patients with small cell lung cancer of favourable prognosis (limited disease, performance status 0-1; limited disease with performance status 2 but normal sodium and alkaline phosphatase, or extensive disease with performance status 0-1, normal sodium and alkaline phosphatase) received treatment with Ifosfamide 3 g/m(2)intravenously, Carboplatin (Glomerular filtration rate + 25) x6 mg intravenously, Etoposide 50 mg orally, twice daily, for 7 days, every 3 weeks. Patients were randomized to receive amifostine 740 mg/m(2)immediately prior to the intravenous drugs (n = 42) or to receive chemotherapy alone (n = 42). The two groups were similar with respect to baseline prognostic factors. There was no significant difference in the occurrence of grade III or IV neutropenia or thrombocytopenia between the two groups, nor in the response rate or overall survival, for which the median was 11 months in the chemotherapy only group and 14 months in the group treated with amifostine. This study has not shown a protective effect from the use of amifostine with this regimen and there does not appear to be any effect upon the efficacy of treatment.