Cisplatin and Etoposide for Small Cell Lung Cancer

Small cell lung cancer (SCLC) is a type of lung cancer that accounts for about 15% of all lung cancers. SCLC is characterized by rapid growth and early spread to other organs. SCLC is usually caused by smoking and is more common in men than in women. SCLC is classified into two stages: limited stage, when the cancer is confined to one lung and nearby lymph nodes; and extensive stage, when the cancer has spread beyond the lung to other parts of the body.

Chemotherapy is the main treatment for SCLC, as surgery and radiation therapy are usually not effective or feasible. Chemotherapy is the use of drugs to kill cancer cells or stop them from growing. Chemotherapy can be given alone or in combination with other drugs, depending on the stage and the response of the cancer.

Cisplatin and etoposide are two chemotherapy drugs that are commonly used to treat SCLC. Cisplatin belongs to a group of drugs called platinum-based agents, which are effective against many types of cancer, especially lung cancer. Etoposide belongs to a group of drugs called topoisomerase inhibitors, which interfere with the DNA replication and repair of cancer cells.

How do cisplatin and etoposide work?

Cisplatin and etoposide work by damaging the DNA of cancer cells, which prevents them from dividing and multiplying. DNA is the genetic material that controls all the functions of the cell. When the DNA is damaged, the cell either dies or stops growing. Cisplatin and etoposide can also affect the DNA of normal cells, which can cause side effects.

How are cisplatin and etoposide given?

Cisplatin and etoposide are given as injections or infusions into a vein (intravenously). The dose and frequency of cisplatin and etoposide depend on the type and stage of SCLC, the patient's kidney function, body weight, and surface area, and other factors. Cisplatin and etoposide are usually given in cycles of treatment, with a period of rest between each cycle. Each cycle may last from 3 to 6 weeks.

Cisplatin and etoposide can be given alone or in combination with other chemotherapy drugs, such as carboplatin, irinotecan, or paclitaxel. The combination of drugs may vary depending on the subtype of SCLC (small cell or mixed), whether it has spread to other parts of the body (metastatic or non-metastatic), and whether it is given before or after surgery or radiation therapy (neoadjuvant or adjuvant).

Cisplatin and Etoposide for Small Cell Lung Cancer

What are the benefits of cisplatin and etoposide?

Cisplatin and etoposide can shrink tumors and improve symptoms of SCLC, such as coughing, chest pain, shortness of breath, or weight loss. Cisplatin and etoposide can also increase the survival and quality of life of patients with SCLC. For some patients with limited-stage SCLC, cisplatin and etoposide can be given before surgery or radiation therapy to reduce the size of the tumor and make it easier to remove (neoadjuvant therapy). For some patients with extensive-stage SCLC, cisplatin and etoposide can be given after surgery or radiation therapy to kill any remaining cancer cells and prevent recurrence (adjuvant therapy).

What are the side effects of cisplatin and etoposide?

Cisplatin and etoposide can cause side effects that affect different parts of the body. The most common side effects are:

Low blood cell counts: Cisplatin and etoposide can lower the number of red blood cells (anemia), white blood cells (neutropenia), and platelets (thrombocytopenia) in the blood. This can cause fatigue, weakness, infections, bleeding, or bruising.
Nausea and vomiting: Cisplatin and etoposide can stimulate the vomiting center in the brain and irritate the stomach lining. This can cause nausea and vomiting, which can be mild or severe.
Hair loss: Cisplatin and etoposide can damage the hair follicles and cause hair loss (alopecia). This can affect the scalp, eyebrows, eyelashes, or other parts of the body.
Kidney damage: Cisplatin can affect the function of the kidneys and cause kidney damage (nephrotoxicity). This can lead to high levels of creatinine or urea in the blood, which indicate poor kidney function.
Nerve damage: Cisplatin can damage the nerves and cause nerve damage (neuropathy). This can cause numbness, tingling, pain, or weakness in the hands or feet.
Hearing loss: Cisplatin can damage the inner ear and cause hearing loss (ototoxicity). This can affect high-frequency sounds or speech recognition.
Allergic reactions: Cisplatin and etoposide can trigger an allergic reaction in some people. This can cause rash, itching, swelling, difficulty breathing, or low blood pressure.

The severity and duration of side effects vary from person to person and depend on the dose and schedule of cisplatin and etoposide. Some side effects may be temporary and resolve after treatment is completed. Some side effects may be permanent and require long-term monitoring or treatment. Some side effects may be prevented or managed with medications, dietary changes, or supportive care. Patients should report any side effects to their doctor or nurse and follow their advice on how to cope with them.

Conclusion

Cisplatin and etoposide are two chemotherapy drugs that are widely used to treat SCLC. Cisplatin and etoposide can kill cancer cells or stop them from growing by damaging their DNA. Cisplatin and etoposide can be given alone or in combination with other drugs, depending on the type and stage of SCLC. Cisplatin and etoposide can improve the outcomes and quality of life of patients with SCLC, but they can also cause side effects that affect different parts of the body. Patients should be aware of the benefits and risks of cisplatin and etoposide and discuss them with their doctor before starting treatment.

Bibliography

[1] American Cancer Society. What Is Small Cell Lung Cancer? Available from: https://www.cancer.org/cancer/small-cell-lung-cancer/about/what-is-small-cell-lung-cancer.html.

[2] National Cancer Institute. Small Cell Lung Cancer Treatment (PDQ®)--Patient Version. Available from: https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq.

[3] Cancer Research UK. Cisplatin and Etoposide. Available from: https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/cancer-drugs/drugs/cisplatin-and-etoposide.

[4] ChemoExperts. Cisplatin + Etoposide (EP) for Lung Cancer (SCLC). Available from: https://www.chemoexperts.com/cisplatin-etoposide-sclc.html.