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The primary objective of this phase II study was to determine whether epigenetic modulation with valproic acid in addition to a doxorubicin, vindesine and cyclophosphamide (VAC) regimen improves 6-month progression-free survival (PFS).<\/jats:p><jats:p>Patients with pathologically proven SCLC refractory to prior platinum derivatives and etoposide were eligible. After central registration, patients received VAC plus daily oral valproic acid.<\/jats:p><jats:p>64 patients were registered, of whom six were ineligible. Seven patients did not receive any CT, leaving 51 patients assessable for the primary end-point. The objective response rate was 19.6%. Median PFS was 2.8\u2005months (95% CI 2.5\u20133.6\u2005months) and 6-month PFS was 6%. Median survival time was 5.9\u2005months (95% CI 4.7\u20137.5\u2005months). Toxicity was mainly haematological, with 88% and 26% grade 3\u20134 neutropenia and thrombopenia, respectively.<\/jats:p><jats:p>Despite an interesting response rate, the addition of valproic acid to VAC did not translate into adequate PFS in relapsing SCLC or SCLC refractory to platinum\u2013etoposide.<\/jats:p>","DOI":"10.1183\/23120541.00029-2015","type":"journal-article","created":{"date-parts":[[2015,10,20]],"date-time":"2015-10-20T04:30:16Z","timestamp":1445315416000},"page":"00029-2015","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["VAC chemotherapy with valproic acid for refractory\/relapsing small cell lung cancer: a phase II 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