Autologous Bone Marrow Transplantation - Blog Science Connections

Lung Cancer
G. Spitzer and H. Lazarus, Chairmen
DR. W. "BILL" PETERS: AS I recall from Steve Wolffs publications, the
maximum tolerated dose (MTD) of VP-16-213 (etoposide) was about 2400
mg/m 2
in his studies. Is the difference you're seeing in the MTD related to the
schedule or what?
DR. S. WOLFF: I was going to ask Hillard (Dr. Lazarus) how long the
etoposide is infused by a syringe. Is it a rapid infusion or a prolonged,
continuous infusion of etoposide?
DR. H. LAZARUS: The etoposide, as I indicated, is given over 4 hours. In
response to Bill's question, as I recall you were at the microphone, Steve, your
dose-limiting toxicity was 2400 because when you got to 2700 many of the
patients had what was termed unacceptable mucositis which, in retrospect,
may well have been owed to things such as herpes simplex or other types of
infection. We have used acyclovir in the patients that are antibody positive and I
think we may have resolved that problem. I don't really know that there is a
ceiling for etoposide under those conditions. 1 think the data suggested we can
continue to escalate the dose.
DR. PETERS: Have you looked at the pharmacy of the drug in the syringe?
Does the drug stick to the walls or anything?
DR. LAZARCIS: We've measured serum concentrations in several of these
patients and they're very, very high. In fact, we sent some of the samples to Steve
523