Hi - thought some of you may be interested in the enclosed abstract from the new england journal of medicine about this newer chemo agent vs. the usual agents.

Has anyone out there every tried or heard of
irinotecan?

Also, what is the "vacine" for small cell lung cancer that some people who have posted have made reference to. I've never heard of it and would appreciate any info.
abstract follows
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Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive
small-cell lung cancer.

Noda K, Nishiwaki Y, Kawahara M, Negoro S, Sugiura T, Yokoyama A, Fukuoka M,
Mori K, Watanabe K, Tamura T, Yamamoto S, Saijo N; The Japan Clinical Oncology
Group.

Kanagawa Cancer Center, Yokohama, Japan.

BACKGROUND: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective
against small-cell lung cancer. In a phase 2 study of irinotecan plus cisplatin
in patients with extensive small-cell lung cancer, there was a high response
rate and a promising median survival time. METHODS: We conducted a multicenter,
randomized, phase 3 study in which we compared irinotecan plus cisplatin with
etoposide plus cisplatin in patients with extensive (metastatic) small-cell lung
cancer. RESULTS: The planned size of the study population was 230 patients, but
enrollment was terminated early because an interim analysis found a
statistically significant difference in survival between the patients assigned
to receive irinotecan and cisplatin and those assigned to receive etoposide and
cisplatin; as a result, only 154 patients were enrolled. The median survival was
12.8 months in the irinotecan-plus-cisplatin group and 9.4 months in the
etoposide-plus-cisplatin group (P=0.002 by the unadjusted log-rank test). At two
years, the proportion of patients surviving was 19.5 percent in the
irinotecan-plus-cisplatin group and 5.2 percent in the etoposide-plus-cisplatin
group. Severe or life-threatening myelosuppression was more frequent in the
etoposide-plus-cisplatin group than in the irinotecan-plus-cisplatin group, and
severe or life-threatening diarrhea was more frequent in the
irinotecan-plus-cisplatin group than in the etoposide-plus-cisplatin group.
CONCLUSIONS: Irinotecan plus cisplatin is an effective treatment for metastatic
small-cell lung cancer.

My husband was diagnosed with extensive sclc in late February and he is in a clinical study using the combination of the above referenced chemo drugs. After four treatments, the results were remarkable!!! We have two more treatments and then CAT scans will be repeated to see the the progress is continuing. At this point, the results are remarkable and the side effects have been minimal. He had only one day of nausea. He did have some minor cramping due to low sodium levels but additional fluids took care of that problem. He is on his second roung of nupogen to improve the white cell count but that treatment is also working great! I am as optomistic as I can be dealing with this type of cancer.