Topotecan monotherapy for the treatment of relapsed small cell lung cancer in elderly patients: A retrospective analysis

Autor:	Mie Kotake, Takayuki Kaburagi, Tomohide Sugiyama, Yoichi Nakamura, Yoko Shibata, Takashi Kasai, Koichi Minato, Hisao Imai, Kyoichi Kaira, Hiroyuki Minemura, Yutaka Yamada, Kenya Kanazawa
Rok vydání:	2018
Předmět:	0301 basic medicine Pulmonary and Respiratory Medicine Response rate (survey) medicine.medical_specialty Leukopenia Anemia business.industry General Medicine Neutropenia medicine.disease Gastroenterology 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Oncology Refractory 030220 oncology & carcinogenesis Internal medicine medicine Topotecan medicine.symptom Adverse effect business Febrile neutropenia medicine.drug
Zdroj:	Thoracic Cancer. 9:1699-1706
ISSN:	1759-7706
DOI:	10.1111/1759-7714.12884
Popis:	Background Topotecan is one of the most active chemotherapeutic drugs for small cell lung cancer (SCLC). However, its efficacy in elderly patients with SCLC has not been validated. This study evaluated the feasibility and efficacy of topotecan monotherapy in elderly patients with relapsed SCLC. Methods Between January 2000 and March 2017, 43 patients aged ≥ 70 years received topotecan monotherapy for relapsed SCLC at four institutions. The clinical outcomes and adverse events of treatment were retrospectively analyzed. Results Twenty-nine patients (median age 75 years; range: 70-83 years) had sensitive-type relapse, while 14 (median age 78 years; range: 71-82 years) had refractory relapse. The median number of treatment cycles was two (range: 1-6). The response rate was 7.0% (10.3% and 0% in sensitive and refractory patients, respectively), while the disease control rate was 23.2% (20.6% and 42.8% in sensitive and refractory patients, respectively). Median progression-free survival was 1.9 months in sensitive patients and 1.4 months in refractory patients (P = 0.87). The median survival time from the start of topotecan therapy was 5.5 months in sensitive patients and 4.0 months in refractory patients (P = 0.64). Grade ≥ 3 hematological toxicities were as follows: leukopenia, 37.2%; neutropenia, 51.1%; anemia, 0%; thrombocytopenia, 32.5%; and febrile neutropenia, 9.3%. No treatment-related deaths occurred. Conclusion Although hematological toxicities (particularly neutropenia) were severe, topotecan showed favorable disease control in both sensitive and refractory patients. Topotecan may thus be a preferred treatment for elderly patients with relapsed SCLC.
Databáze:	OpenAIRE
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