This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Héron, J.-F. Search for Related Content PubMed PubMed Citation Articles by Héron, J.-F.

Topotecan: An Oncologist's View

Centre François Baclesse, Centre Régional de Lutte Contre le Cancer, Caen, France

Correspondence: Jean-François Héron, M.D., Centre François Baclesse, Centre Régional de Lutte Contre le Cancer, Route de Lion sur Mer, 14076 Caen, France. Telephone: 33-2-31-45-50-00; Fax: 33-2-31-45-50-18; e-mail: jfheron{at}baclesse.fr

Topotecan (Hycamtin^®) is a topoisomerase I inhibitor which demonstrated a wide spectrum of antitumor activity in preclinical models. During phase I assessment, evidence of activity was most promising when topotecan was administered on an i.v. daily x 5 schedule and a dose of 1.5 mg/m²/day was selected for phase II/III evaluation. This regimen has been shown to have activity in a wide range of tumor types, including recurrent ovarian cancer, relapsed small cell lung cancer (SCLC), non-small cell lung cancer, colon cancer, and breast cancer, as well as hematological malignancies. In patients with ovarian cancer who had failed standard therapy, topotecan demonstrated response rates of 13% to 25%, with median times to progression of 12 to 19 weeks. Compared with paclitaxel, the response rates were similar, 20.5% and 14.0%, respectively, as were median times to progression (19 weeks for topotecan versus 15 weeks for paclitaxel). Results in recurrent SCLC have also been encouraging. Patients sensitive to previous chemotherapy have shown response rates of 19% and 39%, and even patients resistant or refractory to previous chemotherapy have had responses of 3% and 7%. Survival ranged from 20 weeks in refractory disease to 12 months in both sensitive and resistant/refractory disease combined. The safety profile of topotecan is well established. The principal toxicity is noncumulative myelosuppression, and serious sequelae are uncommon. Nonhematological toxicities are generally mild. The use of topotecan in combination regimens is promising, although clinical results are currently at an early stage. To date, topotecan has demonstrated its activity in recurrent ovarian cancer and offers a valuable addition to treatment options in relapsed SCLC.

Key Words. Topotecan • Clinical trials • Ovarian neoplasms • Small cell lung carcinoma • Leukemia • Review

This article has been cited by other articles:

				A. K. Larsen, C. Gilbert, G. Chyzak, S. Y. Plisov, I. Naguibneva, O. Lavergne, L. Lesueur-Ginot, and D. C. H. Bigg Unusual Potency of BN 80915, a Novel Fluorinated E-ring Modified Camptothecin, toward Human Colon Carcinoma Cells Cancer Res., April 1, 2001; 61(7): 2961 - 2967. [Abstract] [Full Text]

				B. J. Fisher, C. Scott, D. R. Macdonald, C. Coughlin, and W. J. Curran Phase I Study of Topotecan Plus Cranial Radiation for Glioblastoma Multiforme: Results of Radiation Therapy Oncology Group Trial 9507 J. Clin. Oncol., February 15, 2001; 19(4): 1111 - 1117. [Abstract] [Full Text] [PDF]