Efficacy of Platinum-Based Chemotherapy for Relapsed Small-Cell Lung Cancer after Amrubicin Monotherapy in Elderly Patients and Patients with Poor Performance Status

Oncology. 2018;94(4):207-214. doi: 10.1159/000486038. Epub 2018 Jan 31.

Abstract

Background: Previous studies have shown amrubicin to be an effective first- or second-line treatment option for small-cell lung cancer (SCLC). However, there have been few studies reporting the efficacy of platinum-based chemotherapy after amrubicin therapy. We aimed to evaluate the efficacy of platinum-based chemotherapy as second-line treatment for elderly patients and those with SCLC with poor performance status (PS) previously treated with amrubicin monotherapy.

Methods: The records of SCLC patients who received platinum-based chemotherapy as a second-line chemotherapy after first-line treatment with amrubicin monotherapy were retrospectively reviewed and the treatment outcomes were evaluated.

Results: A total of 48 patients were enrolled in this study. Forty-one patients (85%) received carboplatin plus etoposide. The overall response rate was 39.6%. The median progression-free survival and overall survival were 3.7 and 7.6 months, respectively. The efficacy of the platinum-based regimen did not differ with the type of relapse after amrubicin monotherapy. The most common adverse events were hematological toxicities, including grade 3 or 4 neutropenia (38%), leukopenia (33%), and thrombocytopenia (10%).

Conclusions: Platinum-based chemotherapy is potentially a valid treatment option for elderly patients or those with extensive-stage SCLC with poor PS as second-line chemotherapy, who progressed after first-line treatment with amrubicin monotherapy.

Keywords: Amrubicin; Elderly patients; Platinum-based chemotherapy; Poor performance status; Small-cell lung cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anthracyclines / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Carboplatin / administration & dosage
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Etoposide / administration & dosage
  • Female
  • Health Status*
  • Humans
  • Irinotecan
  • Leukopenia / chemically induced
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neutropenia / chemically induced
  • Response Evaluation Criteria in Solid Tumors
  • Retrospective Studies
  • Small Cell Lung Carcinoma / drug therapy*
  • Small Cell Lung Carcinoma / secondary
  • Survival Rate
  • Thrombocytopenia / chemically induced

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Etoposide
  • Irinotecan
  • amrubicin
  • Carboplatin
  • Cisplatin
  • Camptothecin