Clinical trial of high-dose etoposide

In eleven patients with recurrent or refractory malignant lymphomas or lung cancers, a phase I study of high-dose etoposide without autologous bone marrow transplantation was performed. As a starting dose of etoposide 200 mg/m2 was administered for five consecutive days and the daily dose was increased step by step to a dose of 50 mg/m2. The dose of etoposide was escalated in order to define dose-limiting extramedullary toxicity, which was oropharyngeal mucositis and arrhythmias (PVC) at a dose level of 350 mg/m2/day. Bone marrow toxicity was completely reversible, supported by thrombocyte transfusion and antibiotics. Of nine evaluable patients with malignant lymphomas, two complete remissions and one partial remission were obtained. However, some patients unresponsive to standard-dose etoposide did not exhibit any response to the augmented dose of etoposide. Etoposide is thus a suitable drug for high-dose chemotherapy.