Park, Se Hoon; Cho, Eun Kyung; Kim, Yujin; Kyung, Sun Young; An, Chang Hyeok; Lee, Sang Pyo; Park, Jeong Woong; Jeong, Sung Hwan; Lee, Jae-Ik; Choi, Soo Jin; Park, Jinny; Shin, Dong Bok; Lee, Jae Hoon
Cancer chemotherapy and pharmacology
2008Nov ; 62 ( 6 ) :1009-14.
PMID : 18259751
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Park, Se Hoon -
Cho, Eun Kyung -
Kim, Yujin -
Kyung, Sun Young -
An, Chang Hyeok -
Lee, Sang Pyo -
Park, Jeong Woong -
Jeong, Sung Hwan -
Lee, Jae-Ik -
Choi, Soo Jin -
Park, Jinny -
Shin, Dong Bok -
Lee, Jae Hoon -
ABSTRACT
PURPOSE: Although the efficacy of topotecan as a second-line chemotherapy for small-cell lung cancer (SCLC) has been consistently demonstrated in phase II/III clinical trials, the choice of irinotecan as the first-line therapy prevented the use of evidence-based option. This pilot study was conducted to determine the activity and safety of topotecan in SCLC patients refractory to first-line therapy with irinotecan and platinum.
METHODS: Patients with primary refractory (no response, or progression during or < or =90 days after last chemotherapy) SCLC after treatment with a combination of irinotecan and platinum, received topotecan 1.5 mg/m(2) per day as a 30-min infusion daily for 5 days, every 3 weeks.
RESULTS: Of 17 eligible patients, ten patients were previously treated with irinotecan plus cisplatin and 7 were treated with irinotecan plus carboplatin. The median age was 68 years (range 44-75) and the median interval from the last chemotherapy was 50 days (range 21-89). A total of 33 chemotherapy cycles were delivered (median 2; range 1-5). All 17 patients discontinued therapy due to disease progression and 5 patients had progressive disease before second cycle. Toxic effects were mainly hematologic (grade > or =3 neutropenia in 65% of patients) and fatigue (grade 3 in 47%). In an intent-to-treat analysis, two (12%) patients had a confirmed partial response and two patients achieved stable disease. Median progression-free and overall survivals were 1.7 months (95% CI, 1.5-1.9) and 3.4 months (95% CI, 1.7-5.0), respectively.
CONCLUSIONS: Topotecan monotherapy for patients with irinotecan-refractory SCLC does not appear highly active but the observation of some responses merits further study in patients with chemosensitive disease.
Small-cell lung cancer, Refractory, Chemotherapy, Topotecan
MESH
Adult, Aged, Antineoplastic Agents/adverse effects/*therapeutic use, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Camptothecin/administration & dosage/analogs & derivatives/pharmacology, Carboplatin/administration & dosage, Carcinoma, Small Cell/*drug therapy, Cisplatin/administration & dosage, Disease Progression, Disease-Free Survival, Drug Resistance, Neoplasm, Female, Humans, Lung Neoplasms/*drug therapy, Male, Middle Aged, Pilot Projects, *Salvage Therapy, Survival Analysis, Topotecan/adverse effects/*therapeutic use
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