Phase II trial of iproplatin in advanced squamous cell carcinoma of the head and neck, oesophagus and lung

Clinical development of platinum complexes in cancer therapy: an historical perspective and an update

The vast amount of basic research on platinum coordination complexes has produced, over the past 25 years, several thousand new molecules for preclinical screening and 28 compounds which have entered clinical development. The goals of these research activities have been to identify compounds with superior efficacy, reduced toxicity, lack of cross-resistance or improved pharmacological characteristics as compared with the parent compound, cisplatin. After the remarkable therapeutic effects of cisplatin had been established, only a few other platinum compounds succeeded in reaching general availability. Whereas carboplatin is an analogue with an improved therapeutic index (mostly driven by reduced organ toxicity) over that of cisplatin, new compounds clearly more active than or non-cross-resistant with cisplatin have not yet been identified. The platinum analogues that remain under investigation are focusing on expanding the utilisation of platinum therapy to tumour types not usually treated with, or responsive to, cisplatin or carboplatin. In addition, novel routes of administration constitute another avenue of research. The clinical development of platinum coordination complexes, with emphasis on those compounds still under active development, is reviewed.

Cisplatin and etoposide in oesophageal cancer: a phase II study. Rotterdam Oesophageal Tumour Study Group

In the search for effective chemotherapy regimens which can be used in multimodality treatment programmes for patients with cancer of the oesophagus, we conducted a phase II trial to determine the activity and toxicity of the combination of cisplatin and etoposide in patients with advanced squamous cell carcinoma of the oesophagus. Seventy-three consecutive patients with unresectable or metastatic squamous cell carcinoma of the thoracic oesophagus were treated with cisplatin 80 mg m-2 by 4 h infusion on day 1, etoposide 100 mg (fixed dose) by 2 h infusion on day 1 and 2, and etoposide 200 mg m-2 orally on day 3 and 5. Courses were repeated every 4 weeks, for a maximum of six courses. The oral dosages of etoposide were modified individually until a significant degree of myelosuppression was reached. Of 65 evaluable patients, five complete responses (CRs) and 26 partial responses (PRs) were seen, for an overall response rate of 48% (95% confidence interval 35-60%). Median time to progression was 7 months (range 3-72 + months). There were two toxic deaths (neutropenic sepsis). The response rate equals that of other cisplatin-based regimens. Its toxicity profile allows addition of a third active drug such as 5-fluorouracil.