Low-dose irinotecan as a second-line chemotherapy for recurrent small cell lung cancer.

Abstract

OBJECTIVE:

Irinotecan is a potent inhibitor of deoxyribonucleic acid topoisomerase 1 and the weekly schedule of 100-125 or 350 mg/m(2) administration on Day 1 every 3 weeks is recommended for recurrent small cell lung cancer. However, severe gastrointestinal toxic effects and myelosuppression are often observed in this dose setting. We conducted a retrospective study to evaluate the efficacy and safety of low-dose irinotecan monotherapy (60 mg/m(2) on Days 1, 8 and 15 every 4 weeks) as second-line chemotherapy for small cell lung cancer.

METHODS:

The medical charts of small cell lung cancer patients who had received second-line chemotherapy at the National Cancer Center Hospital East between April 2003 and June 2012 were reviewed. Consecutive 57 patients who were treated with low dose of irinotecan (60 mg/m(2) on Days 1, 8 and 15 every 4 weeks) were analyzed in this study.

RESULTS:

Median age was 70 years (range, 51-83). Fifty-two (91%) were male, 36 (63%) had an Eastern Cooperative Oncology Group performance status 0-1 and 26 (46%) were sensitive relapse. The median number of chemotherapy cycles was 2. The objective response rate was 32% (95% confidence interval: 20-45%).The median progression-free survival and the median overall survival were 2.9 months (95% confidence interval: 1.9-3.4 months) and 5.3 months (95% confidence interval: 3.6-7.6 months), respectively. The incidence of Grade 3/4 neutropenia, diarrhea and nausea/vomiting was 21, 4 and 5%, respectively.

CONCLUSIONS:

Low-dose irinotecan monotherapy for recurrent small cell lung cancer might be effective with favorable toxicity. Randomized trial of 60 mg/m(2) versus standard dose of irinotecan is warranted.

• Authors: Masahiro Morise, Seiji Niho, Shigeki Umemura, Shingo Matsumoto, Kiyotaka Yoh, Koichi Goto, Hironobu Ohmatsu, Yuichiro Ohe
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 44 Issue 9 Pg. 846-51 (Sep 2014) ISSN: 1465-3621 [Electronic] England
• PMID: 25057092 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Antineoplastic Agents, Phytogenic
• Irinotecan
• Camptothecin

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Agents, Phytogenic (administration & dosage, adverse effects, therapeutic use)
• Camptothecin (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Diarrhea (chemically induced)
• Disease-Free Survival
• Drug Administration Schedule
• Female
• Humans
• Infusions, Intravenous
• Irinotecan
• Kaplan-Meier Estimate
• Lung Neoplasms (drug therapy, pathology)
• Male
• Medical Records
• Middle Aged
• Nausea (chemically induced)
• Neoplasm Recurrence, Local (drug therapy)
• Neutropenia (chemically induced)
• Retrospective Studies
• Severity of Illness Index
• Small Cell Lung Carcinoma (drug therapy, pathology)
• Treatment Outcome
• Vomiting (chemically induced)