Extended administration of oral etoposide and oral cyclophosphamide for the treatment of advanced non-small-cell lung cancer: A southwest oncology group study

Purpose: We designed an all-oral regimen of etoposide and cyclophosphamide for use in advanced non-small-cell lung cancer. Patients and Methods: Eligible patients were chemotherapy-naive and had histologically confirmed assessable or measurable stage IV non-small-cell lung cancer. Patients received etoposide 50 mg/m²/d orally days 1 through 14 and cyclophosphamide 50 mg/m²/d orally days 1 through 14 every 28 days. Doses on later cycles were adjusted for myelosuppression. Results: Sixty-six patients (64 eligible patients) received 192 cycles of oral extended etoposide/cyclophosphamide therapy (median, two cycles; range, zero to 15). Therapy was well tolerated with the mean dose per cycle being 104% of the originally scheduled dose. Two patients (3%) achieved a complete response and six (9%) achieved a partial response. Leukopenia, anemia, nausea/vomiting, and alopecia were the most common toxicities. Median survival was 6 months, and the 1-year survival rate was 25.6%, comparable to more intensive treatments. Conclusion: Oral extended etoposide/cyclophosphamide is a well-tolerated alternative for the treatment of stage IV non-small-cell lung cancer and can be used as a basis for the design of further outpatient regimens.