Amrubicin monotherapy for elderly patients with relapsed extensive‐disease small‐cell lung cancer: A retrospective study

Abstract

BackgroundPrevious studies have shown amrubicin (AMR) to be an effective second‐line treatment option for small‐cell lung cancer (SCLC). However, the efficacy of AMR in elderly patients with relapsed SCLC has not been sufficiently evaluated.MethodsThe medical records of elderly patients with relapsed SCLC who received AMR as second‐line chemotherapy were retrospectively reviewed, and their treatment outcomes were evaluated.ResultsThirty‐one patients with a median age of 72 years (22 patients with sensitive relapse and 9 with refractory relapse) were analyzed. The median number of treatment cycles was four (range: 1–10), and the response rate was 29%. The median progression‐free survival (PFS) and overall survival (OS) were 5.4 and 11.6 months, respectively. The OS of 22 patients who received third‐line chemotherapy was 15.5 months. The PFS (6.2 vs. 3.2 months; P = 0.002) and OS (14.8 vs. 5.7 months; P = 0.004) were significantly longer in patients with sensitive relapse than those with refractory relapse. The frequency of grade 3 or higher neutropenia was high (n = 18, 58%), while febrile neutropenia was only observed in five patients (16%). Non‐hematological toxic effects were relatively mild, and pneumonitis and treatment‐related deaths were not observed.ConclusionAMR may be a feasible and effective regimen for elderly patients with relapsed SCLC.

The efficacy of amrubicin third‐line chemotherapy in patients with relapsed extensive‐disease small‐cell lung cancer: A retrospective and historical study in a single institute

“…With regard to toxicity, higher incidences of febrile neutropenia were observed with amrubicin, but there were no treatment‐related deaths. The frequencies of grade 3 or 4 hematologic toxicities in the present study, such as anemia and thrombocytopenia, were comparable to previous studies . In a retrospective study of advanced non‐SCLC patients receiving amrubicin as a third‐ or more‐line chemotherapy, grade 3 or 4 hematologic toxicities included neutropenia (61.1%), leukopenia (58.3%), thrombocytopenia (22.2%), and anemia (11.1%) .…”

Real-world treatment patterns and outcomes in small-cell lung cancer: a systematic literature review

“…A further 16 and 2 studies reported on PCI and maintenance therapies following induction chemotherapy in first-line SCLC, respectively. Twenty-six studies reported disease functioning scales, most commonly the ECOG performance status (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), or the Karnofsky performance status (31)(32)(33)(34)(35)(36). Demographics of patients from the quantitative studies matched the SCLC patient profile described in the literature (37), whereby patients are likely to be male and over 50 years of age.…”

“…Eleven studies were identified specific to ES patients in the first-line setting (18,31,32,36,(48)(49)(50)(51)(52)(53)(54)(55). No studies reported use of immunotherapy agents.…”

“…In all studies reporting OS in ES SCLC patients receiving first-line treatment, median OS was below 2 years, with median OS ranging between 5.9-18 months [12 studies (18,31,32,36,(48)(49)(50)(51)(52)(53)(54)(55); Figure 2D]. Amongst those patients who received platinum-based chemotherapy alone in the first-line setting, median OS ranged from 9.3-13 months (18,49,50,(52)(53)(54). The median PFS in ES SCLC following first-line treatment [10 studies (18,31,32,36,(48)(49)(50)(51)(52)54)] was 5-10 months.…”

“…Amongst those patients who received platinum-based chemotherapy alone in the first-line setting, median OS ranged from 9.3-13 months (18,49,50,(52)(53)(54). The median PFS in ES SCLC following first-line treatment [10 studies (18,31,32,36,(48)(49)(50)(51)(52)54)] was 5-10 months. In the 2nd and 3rd line settings [17 studies (21,23,24,28,40,61-67,71-75)], both PFS and OS were considerably shorter (PFS 1.5-8.2 months; OS see Figure 2E).…”