Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease.

Abstract

PURPOSE:

To investigate the safety of intravenous topotecan monotherapy for relapsed small cell lung cancer (SCLC) patients with pre-existing interstitial lung disease (ILD).

METHODS:

A total of 77 patients who received topotecan for the treatment of relapsed SCLC between April 2007 and April 2014 were reviewed. Patients with pre-existing ILD were identified using the pretreatment chest computed tomography. The safety of intravenous topotecan for SCLC patients with ILD was retrospectively examined, particularly focusing on topotecan-induced acute exacerbation of ILD (AE-ILD).

RESULTS:

Twenty-three patients were identified as having pre-existing ILD [median age 74 (range 55-85) years; 21 men]. At the first topotecan administration, two-thirds (65.2%) had an Eastern Cooperative Oncology Group performance status 0 or 1. Topotecan was administered intravenously as second-line (n = 11) or later chemotherapy (n = 12). The median number of treatment cycles was two (range 1-7). The most common adverse events with grade 3 or 4 were neutropenia in 13 patients (56.5%) and thrombocytopenia in 10 patients (43.5%). Febrile neutropenia was observed in six patients (26.1%) and resulted in one death. AE-ILD occurred in five patients (21.7%; 95% confidence interval 4.9-38.5 %) 5-18 days after the last administration of topotecan and was fatal in three cases.

CONCLUSIONS:

Intravenous topotecan monotherapy can be unsafe for relapsed SCLC patients with pre-existing ILD. Clinicians should be cautious regarding topotecan-induced AE-ILD as a lethal complication.

• Authors: Yasunori Enomoto, Naoki Inui, Shiro Imokawa, Masato Karayama, Hirotsugu Hasegawa, Yuichi Ozawa, Takashi Matsui, Koshi Yokomura, Takafumi Suda
• Journal: Cancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 76 Issue 3 Pg. 499-505 (Sep 2015) ISSN: 1432-0843 [Electronic] Germany
• PMID: 26134440 (Publication Type: Journal Article)

Chemical References

• Topoisomerase I Inhibitors
• Topotecan

Topics

• Aged
• Aged, 80 and over
• Female
• Humans
• Lung Diseases, Interstitial (drug therapy, physiopathology)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, physiopathology)
• Retrospective Studies
• Small Cell Lung Carcinoma (drug therapy, physiopathology)
• Topoisomerase I Inhibitors (adverse effects, therapeutic use)
• Topotecan (adverse effects, therapeutic use)