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

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.

Phase 2 study of NAB-paclitaxel in SensiTivE and refractory relapsed small cell lung cancer (SCLC) (NABSTER TRIAL)

“…In fact, all patients had ECOG PS 0 or 1, one third of them had LD-stage, 60% had sensitive recurrent disease, with only 10% and 13% of patients having brain and liver involvement, respectively. 26 Similar results were reported from a multicentre, single-arm Phase 2 basket study of lurbinectedin, a RNA polymerase II inhibitor, in patients across advanced solid tumours. Thirty-seven (35.2%) out of 105 enrolled SCLC patients had a partial response.…”

Comparison of tumor related signaling pathways with known compounds to determine potential agents for lung adenocarcinoma

“…After analyzing these five pathways in CMap, several known compounds were identified. Unsurprisingly, many among the top 10 have been studied for the treatment of LUAD, including etoposide, irinotecan, resveratrol, and daunorubicin . This finding confirms that several well‐known anti‐cancer drugs used in LUAD treatment fulfill their function by targeting the five aforementioned signaling pathways.…”

Copper Complexes as Anticancer Agents Targeting Topoisomerases I and II

“…Top inhibitors used in chemotherapy are limited in number [ 61 , 167 , 168 ]. Top1 inhibitors’ camptothecin derivatives used are irinotecan (colorectal [ 169 ], pancreatic (in combination) [ 170 ], and small cell lung cancers (in clinical trials and in combination) [ 171 , 172 ]), and topotecan (ovarian [ 173 , 174 ], cervical [ 175 ], and small cell lung cancers [ 176 ]). Top2 anticancer drugs commonly used are from the anthracycline group such as doxorubicin (acute leukemia [ 177 ], lymphomas [ 178 ], sarcomas [ 179 , 180 ], and solid tumors [ 181 ]), epirubicin (breast cancer [ 182 ]), valrubicin (bladder cancer [ 183 ]), and idarubicin (acute myeloid leukemia [ 184 ]), from the anthracenedione classes: mitoxantron and pixantron (lymphoma, [ 185 , 186 , 187 ]), and from the epipodopodophyllotoxins group such as etoposide (testicular [ 188 ] and small cell lung cancers [ 189 ]) and teniposide (brain [ 190 ] and small cell lung [ 191 ] cancers, acute lymphocytic leukemia [ 192 ]).…”