Paclitaxel as third-line chemotherapy for small cell lung cancer failing both etoposide- and camptothecin-based chemotherapy.

Abstract

Paclitaxel has been shown to have clinical activity in the treatment of small cell lung cancer (SCLC). However, its role as third-line chemotherapy for SCLC after both etoposide- and camptothecin-based regimens has not been clarified.All patients with refractory SCLC who were treated with paclitaxel-based regimen as third-line chemotherapy between 2005 and 2011 in Seoul National University Bundang Hospital were reviewed retrospectively. Forty patients previously treated with both etoposide- and camptothecin-based chemotherapy were included.The median age of the enrolled patients was 67 years (range, 35-86 years). Most patients (77.5%) received cisplatin plus etoposide as first-line therapy, and camptothecins such as irinotecan or topotecan as second-line therapy. Of 34 patients with measurable lesions, 8 patients (23.5%) achieved partial response and 9 (26.5%) had stable disease. The median progression-free survival (PFS) and overall survival (OS) were 2.5 and 5.9 months, respectively. Predictive factors for OS were performance status (PS) (PS <2 vs ≥2; P = .001), the presence of liver metastasis (P < .001), and number of metastatic sites (<3 vs ≥3; P = .047) in univariate analysis. PS and liver metastasis also remained statistically significant in multivariate analysis. Grade 3 or 4 hematologic toxicity was 20% for neutropenia, and 10% for thrombocytopenia. Other common non-hematological toxicities were peripheral neuropathy and mild liver enzyme elevation.Paclitaxel-based chemotherapy showed modest activity in SCLC patients refractory to both etoposide- and camptothecin-based chemotherapy. PS and presence of liver metastasis were predictive of survival after paclitaxel chemotherapy.

• Authors: Se Hyun Kim, Mi-Jung Kim, Yu Jung Kim, Hyun Chang, Jin Won Kim, Jeong-Ok Lee, Keun-Wook Lee, Jee Hyun Kim, Soo-Mee Bang, Jong Seok Lee
• Journal: Medicine (Medicine (Baltimore)) Vol. 96 Issue 42 Pg. e8176 (Oct 2017) ISSN: 1536-5964 [Electronic] United States
• PMID: 29049199 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Antineoplastic Agents, Phytogenic
• Etoposide
• Paclitaxel
• Cisplatin
• Camptothecin

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents, Phytogenic (administration & dosage, adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects)
• Camptothecin (administration & dosage, adverse effects)
• Cisplatin (administration & dosage, adverse effects)
• Disease-Free Survival
• Drug Resistance, Neoplasm (drug effects)
• Etoposide (administration & dosage, adverse effects)
• Female
• Humans
• Lung Neoplasms (drug therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Metastasis
• Paclitaxel (administration & dosage, adverse effects)
• Retrospective Studies
• Small Cell Lung Carcinoma (drug therapy)
• Treatment Outcome