Raising the chemotherapy dose intensity in patients with small cell lung cancer does not improve survival and has substantial toxicity, researchers report in the April 16 issue of the Journal of the National Cancer Institute.

Serge Leyvraz, M.D., from University Hospital in Lausanne, Switzerland, and colleagues randomly assigned 140 patients with small cell lung cancer to high- or standard-dose chemotherapy with ifosfamide, carboplatin and etoposide. The high-dose arm was supported by transfusion with peripheral blood progenitor cells.

The researchers found that the high- and standard-dose groups had similar three-year survival (18 versus 19 percent), overall response (78 versus 68 percent), and complete response (39 versus 34 percent). The standard-dose group had high hematologic toxicity with 4 percent of patients dying of toxicity, while the high-dose group had severe myelosuppression, with 8 percent of patients dying of toxicity.

In an accompanying editorial, Paul A. Bunn, Jr., M.D., from the University of Colorado Cancer Center in Aurora, Colo., writes "data from this study combined with those from other studies should put an end to the era of high-dose 'desperate' therapies."

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Prepared jointly by the editors of RN and HealthDay's Physicians' Briefing (www.physiciansbriefing.com).