A Phase II Study of Irinotecan for Patients with Previously Treated Small-Cell Lung Cancer

Oncology. 2018;94(4):223-232. doi: 10.1159/000486622. Epub 2018 Feb 14.

Abstract

Objective: Chemotherapy with irinotecan plus cisplatin has shown promise in chemo-naïve small-cell lung cancer (SCLC) patients. However, irinotecan treatment for relapsed or refractory SCLC has not been adequately evaluated. This phase II study evaluated the appropriate treatment schedule of irinotecan as a single agent. This study was designed to determine the antitumor activity, toxicity, and survival in previously treated SCLC patients.

Methods: Previously treated SCLC patients with at least one platinum-based regimen received irinotecan (100 mg/m2) on days 1 and 8, every 3 weeks, until disease progression. The assessment of the response rate was the primary endpoint.

Results: Thirty patients were enrolled, with an objective response rate of 41.3% (95% confidence interval [CI] 25.5-59.3), and a disease control rate of 69%. Median progression-free and overall survival was 4.1 months (95% CI, 2.2-5.4) and 10.4 months (95% CI, 8.1-14), respectively. The grade 3/4 hematological toxicities were neutropenia (36.7%), thrombocytopenia (3.3%), anemia (13.3%), and febrile neutropenia (6.6%). There were no grade 4 nonhematological toxicities. Frequent grade 3 nonhematological toxicities included diarrhea (10%), anorexia (6.6%), and hyponatremia (6.6%).

Conclusions: This phase II study showed a high objective response rate and long survival. Irinotecan monotherapy schedule used was well tolerated, and could be an active treatment option for these patients.

Keywords: Irinotecan; Phase II study; Refractory relapse; Sensitive relapse; Small-cell lung cancer.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Aged
  • Anorexia / chemically induced
  • Antineoplastic Agents, Phytogenic / administration & dosage*
  • Antineoplastic Agents, Phytogenic / adverse effects
  • Camptothecin / administration & dosage
  • Camptothecin / adverse effects
  • Camptothecin / analogs & derivatives*
  • Chemotherapy-Induced Febrile Neutropenia / etiology
  • Diarrhea / chemically induced
  • Disease-Free Survival
  • Drug Administration Schedule
  • Female
  • Humans
  • Hyponatremia / chemically induced
  • Irinotecan
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Response Evaluation Criteria in Solid Tumors
  • Retreatment
  • Small Cell Lung Carcinoma / drug therapy*
  • Survival Rate
  • Thrombocytopenia / chemically induced

Substances

  • Antineoplastic Agents, Phytogenic
  • Irinotecan
  • Camptothecin