Platinum + etoposide (EP / CE)
Platinum plus etoposide has been the chemotherapy backbone of small-cell lung cancer for over 40 years, and is now given with immunotherapy.
Cisplatin or carboplatin with etoposide for 4 (extensive-stage) to 4-6 (limited-stage, with concurrent radiotherapy) cycles. Response rates 60-80% but relapse is near-universal in extensive-stage disease. Carboplatin is preferred with immunotherapy and in frailer patients; cisplatin with concurrent thoracic radiotherapy in fit limited-stage patients.
1.Platinum forms intrastrand DNA crosslinks
- Route
- Intravenous
- Schedule
- Carboplatin AUC 5 day 1 (or cisplatin 75 mg/m² day 1) + etoposide 100 mg/m² days 1-3, every 21 days, 4 cycles
- Dose modifications
- Dose reductions for neutropenia; G-CSF support with concurrent radiotherapy is avoided
- Monitoring
- Blood counts each cycle; renal function and hearing with cisplatin
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1983 | Etoposide approved for SCLC; platinum-etoposide became standard in the 1980s |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Neutropenia (grade 3+) | — | 40% |
| Anaemia | 40% | — |
| Nausea | 50% | — |
| Alopecia | 60% | — |
Range across trials 23-45%. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Landmark trials in OnCo
Latest papers
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