A dose escalation study of topotecan in combination with epirubicin in pretreated patients with small-cell lung cancer

Electrochemical determination of epirubicin in the presence of topotecan as essential anti-cancer compounds using paste electrode amplified with Pt/SWCNT nanocomposite and a deep eutectic solvent

Epirubicin (EP) and topotecan (TP) are two major anti-cancer compounds for the treatment of breast cancer with serious side effects. Hence herein, a carbon paste electrode (CPE) amplified with Pt/SWCNT nanocomposite and a deep eutectic solvent (CPE/DES/Pt-SWCNT) were proposed as an analytical tool for the monitoring of EP in the presence of TP in the real samples. Amplification of sensor was improve EP oxidation signal about 2.73 times. Under the optimized conditions, EP determined by using differential pulse voltammetry (DPV) technique with linear dynamic range of 0.001-500 μM with limit of detection (LOD) of 0.8 nM. The CPE/DES/Pt-SWCNT offered influential ability for monitoring of EP in injection and dextrose saline samples with a recovery range of 97.4%-104.9%.

Treatment of relapsed small-cell lung cancer--a focus on the evolving role of topotecan

Despite the high response rates to chemotherapy, small-cell lung cancer (SCLC) is among the most lethal malignancies. Long-term survival is anecdotal for patients with extensive disease; 5-years survival is < or =5% for those with limited disease. All patients with extensive disease and most patients with limited disease will experience disease progression and become candidates for second-line therapy. Although a number of agents have demonstrated antitumor activity in relapsed SCLC, including paclitaxel, docetaxel, etoposide, cisplatin, and carboplatin, topotecan is the only single agent currently approved in the United States for the treatment of recurrent disease. Topotecan is a novel topoisomerase I inhibitor with established antitumor activity in recurrent SCLC and has a predictable, noncumulative toxicity profile. Furthermore, topotecan has been shown to provide symptom improvement in this predominantly palliative setting. Evidence also suggests that topotecan readily penetrates the blood-brain barrier and might be active in the relatively large subset of SCLC patients who experience brain metastases. This article reviews the clinical utility of topotecan in recurrent SCLC, including its efficacy, tolerability, and quality-of-life effect, when used as monotherapy and in novel combination regimens.

Topoisomerase I interactive agents

Increased insight into the mechanism of interaction of topoisomerase I interactive agents will maximize the therapeutic index and enhance the development of additional agents. Preclinical studies designed to elucidate mechanisms by which the topoisomerase I interactive agents induce cell death will be essential. The role of ABC transporters in resistance to topoisomerase I interactive agents has been recently appreciated and future studies should be directed at circumventing this resistance. The results of preclinical studies must be translated into the design of clinical trials so that these agents can be used rationally. In this regard results of preclinical studies have clearly pointed to the enhanced antitumor activity from protracted dosing of topoisomerase I interactive agents and results of clinical trials are now supporting these preclinical findings. Finally, investigators are trying to understand better the mechanism(s) of the dose-limiting toxicities observed with the currently available topoisomerase I interactive agents in an effort to enable the optimal dosing of these agents. Even though the first priority must be to determine the therapeutic potential of the currently available agents, it is reassuring to know that other topoisomerase I interactive agents are currently under development.