Abstract
Purpose: This study evaluates the clinical outcomes of extensive-stage small-cell lung cancer (SCLC) patients who received Irinotecan-based second-line chemotherapy after platinum-based first-line therapy, especially focused on efficacy and toxicity between single-agent and doublet chemotherapy. Patients and methods: We retrospectively reviewed 83 patients who given irinotecan-based second-line chemotherapy for extensive-stage SCLC. Survival curves were plotted using the Kaplan–Meier method. The Cox proportional hazard model was used for multivariate analysis. Results: Fifty-nine patients received doublet chemotherapy and 24 with single-agent treatment. The objective response rate (ORR) was 23.7% in the doublet group and 25% in the single-agent group (P=0.90). The disease control rate (DCR) was 65.7% and 58.3%, respectively, (P=0.71). The Progression-free survival (PFS) was 3.10 months in the doublet group and 2.10 months in the single-agent group (P=0.35). In the sensitive recurrence group, 27 patients were with doublet chemotherapy and 10 with single-agent treatment. The Median PFS was 4.73 months (95% CI: 4.37-5.09) and 3.83months (95% CI: 2.65-5.02), respectively (P=0.543). In the refractory recurrence group, there were 32 patients with doublet chemotherapy and 14 with single-agent treatment. The median PFS was 2.57 months (95% CI: 2.19-2.93) and 1.40 months (95% CI: 1.13-1.64), respectively (P=0.048). The grade III/IV toxicity in single-agent group is lower than doublet group (45.8% vs.71.2%, P=0.029). No difference was found in cancerrelated symptoms improvement between the doublet and single group (P=0.36). Conclusion: Patients with extensive-stage SCLC could benefit from irinotecan-based second-line treatments. The refractory recurrence patients with doublet treatment obtain a moderate PFS advantage than single-agent chemotherapy.
Highlights
small-cell lung cancer (SCLC) is a quite chemo sensitive malignancy with overall response rates of 60–80% in patients with extensive stage disease
Most patients relapsed within a year of initial treatment and most of them eventually died from disease progression [1]
In the second-line setting, irinotecan monotherapy and doublet chemotherapy showed a promising results in several studies
Summary
SCLC is a quite chemo sensitive malignancy with overall response rates of 60–80% in patients with extensive stage disease. A randomized phase III study comparing etoposide-cisplatin (EP) with irinotecan-cisplatin (IP) in first-line treatment Japan patients with extensive-stage SCLC showed that IP was significantly superior to EP in both response and survival [10]. Both of the EP and IP regimen are thought to be standard first-line regimens for extensive-stage SCLC now-a-days. The effects and toxicities data comparing the single-agent chemotherapy with doublet chemotherapy as second-line treatment are lacking
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
