High-dose carboplatin, cyclophosphamide, etoposide with hematological growth factors, without stem cell support in patients with advanced cancer.

Purpose: Peripheral blood progenitor cell (PBPC) transplantation, introduced into clinical practice to decrease the hematological toxicity of high-dose chemotherapy (HDCT), is both a costly procedure and a potential source of tumor cell reinfusion. The maximum tolerated dose of carboplatin (CB), cyclophosphamide (CT) and etoposide (VP) administered with growth factors without PBPC was determined in a previous phase I study. The aim of this phase II study was to evaluate the activity and toxicity of HDCT with CB, CT and VP administered with growth factors, without PBPC in a group of patients with advanced solid tumors.
Patients and Methods: Forty patients with a median age of 52 years received two consecutive courses of chemotherapy every four weeks, consisting of CT 1500 mg/m2, VP 400 mg/m2 and CB AUC of 7-8. Following chemotherapy, hematological growth factors were administered for 14 days.
Results: Grade 4 leukopenia and thrombocytemia occurred in 40 and 21 patients, respectively. An overall response rate of 72.5% was achieved. After a median 81 months follow-up, median time to progression and overall survival were 29 and 38 months, respectively.
Conclusion: These data indicate that HDCT chemotherapy may be delivered safely without PBPC support. Prolonged responses were observed in patients that had few therapeutic options.