Salvage treatment with topotecan in patients with irinotecan-refractory small cell lung cancer
- Authors
- 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
- Issue Date
- Nov-2008
- Publisher
- Springer Verlag
- Keywords
- small-cell lung cancer; refractory; chemotherapy; topotecan
- Citation
- Cancer Chemotherapy and Pharmacology, v.62, no.6, pp 1009 - 1014
- Pages
- 6
- Indexed
- SCOPUS
- Journal Title
- Cancer Chemotherapy and Pharmacology
- Volume
- 62
- Number
- 6
- Start Page
- 1009
- End Page
- 1014
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65719
- DOI
- 10.1007/s00280-008-0690-1
- ISSN
- 0344-5704
1432-0843
- 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 <= 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 >= 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. Conclusion 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.
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