Efficacy of Topotecan as a Second-Line Treatment of Small-Cell Lung Cancer in Patients with Refractory and Sensitive Disease: Retrospective Study

Park, Hee Sun; Kim, Myoung Hoon; Lee, Yeon Sun; Ahn, Jin Young; Kwan, Sun Jung; Lee, Kue Seong; Kang, Dong Won; Jung, Sung Soo; Kim, Ju Ock; Kim, Sun Young

Abstract

PURPOSE: Chemotherapy is the treatment of choice for small-cell lung cancer (SCLC). Despite the high response rates with first-line therapy, most patients eventually experience disease progression, and finally become candidates for second-line therapy. Topotecan is the only single agent currently approved in the United States for the treatment of a recurrent disease. The aim of this study was to evaluate its efficacy in patients with of previously treated, but relapsed and refractory, SCLC.
MATERIALS AND METHODS
Twenty-five patients, who had taken topotecan as a second-line therapy, between March 1999 and October 2002, were reviewed. The patients were divided into two groups: (1) One group were the patients that had failed the first-line treatment within 3 months from end of the chemotherapy (refractory group, RG); and (2) the other group were those that responded to the first-line treatment, but who progressed 3 months after the end of the chemotherapy (sensitive group, SG). Topotecan was administered, intravenously, at a dose of 1.5 mg/m2, within 30 minutes, for five consecutive days every 3 weeks.
RESULTS
There was only one partial response in the SG (3.8%), but there were 9 stable diseases, 4 in the SG and 5 in the RG; 15.4 and 19.2%, respectively. The median survivals were 6.9 and 5.2 months in SG and RG, respectively (p=0.162). There were ninety-nine chemotherapy cycles. The toxicities were mainly hematological. There were 26 incidences of Grades III and IV neutropenia, and the non hematological toxicities were mild.
CONCLUSION
It was concluded that topotecan is not so effective in the treatment of patients with relapsed and refractory SCLC, despite its predictable and manageable toxicity. The incorporation of topotecan in combination chemotherapy regimens for treatment of SCLC is now warranted.