Irinotecan and carboplatin for treatment of brain metastases from small-cell lung cancer

Abstract

19032 Background: Brain metastasis occurs commonly in patients with small-cell lung cancer (SCLC). Herein we report the efficacy of irinotecan and carboplatin in the treatment of brain metastases from SCLC. In addition, we review the existing data on chemotherapy for brain metastases in SCLC. Methods: Eighty patients with metastatic or relapsed SCLC were enrolled in a phase II trial of irinotecan and carboplatin according to a 2-stage design. Chemonaive patients were treated with irinotecan 200 mg/m2 and carboplatin AUC of 5; whereas chemotherapy-treated patients received irinotecan 150 mg/m2 and carboplatin AUC of 5, every 21 days for 6 cycles. Results: The most common grade III/IV toxicity included neutropenia (50%), anemia (11%), thrombocytopenia (19%), diarrhea (20%) and nausea/emesis (11%). Among the 80 patients, 15 (19%) presented with brain metastases. An analysis of 14 assessable patients with brain metastases revealed an overall response rate of 65% after 2 cycles of chemotherapy, and a median survival of 6 months (1 to 24 months). Upon review of the literature, 8 studies were identified with more than 10 patients who had received chemotherapy for brain metastases from SCLC. Based on these studies, the response rate of brain metastases from SCLC to a variety of chemotherapy ranged from 22 to 85% and median survival of patients ranged from 3 to 9 months. Conclusion: Chemotherapy, including the regimen of irinotecan and carboplatin, is an effective treatment for brain metastases from SCLC. (Supported by Pfizer, Inc. and NCI K24CA10014) Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Pfizer, Inc.