Oral second- and third-line lomustine–etoposide–cyclophosphamide chemotherapy for small cell lung cancer

Lebeau, B.; Chouaïd, C.; Baud, M.; Masanès, Marie-Josée; Febvre, M.

doi:10.1016/j.lungcan.2009.03.024

Cited by 23 publications

(14 citation statements)

References 35 publications

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“…Published studies on the efficacy of systemic therapy in the third-line plus setting are sparse, and most of them are single-centre retrospective or small single-arm trials. 27 – 29 Two large-scale multicentre international retrospective studies have been reported, and all showed the effectiveness of active systemic therapy compared with best supportive care or palliative care. One of them analysed 120 patients from three countries in the third-line setting and found the median progression-free survival and overall survival were 2.0 and 4.7 months, respectively.…”

Section: Discussionmentioning

confidence: 99%

Apatinib in patients with extensive-stage small-cell lung cancer after second-line or third-line chemotherapy: a phase II, single-arm, multicentre, prospective study

Huang

et al. 2019

Br J Cancer

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Background Small-cell lung cancer (SCLC) remains an aggressive cancer with short-term survival due to limited therapeutic options. Apatinib is a small-molecule tyrosine kinase inhibitor that selectively inhibits vascular endothelial growth factor receptor-2. This study aimed to investigate the efficacy and safety of apatinib in patients with extensive-stage (EC) SCLC who had progressed after two or three previous therapies. Methods Eligible patients were histologically confirmed ES-SCLC after two or three previous treatments, including a platinum-based regimen. Patients received apatinib at an initial dose of 500 mg once daily. The primary endpoint was the objective response rate. Results Forty patients were enrolled. At the data cut-off time (November 15, 2018), the median follow-up was 7.4 months; no patients remained on treatment, and five were still in follow-up. An objective response was achieved in 7 of 40 patients (17.5%) in the intention-to-treat population, and 7 of 38 patients (18.4%) in the per-protocol population. The median progression-free survival and overall survival were 3.0 months and 5·8 months, respectively. The most commonly observed grade 3 or greater treatment-related adverse events were hypertension, hand–foot syndrome, increased L-gamma-glutamyltransferase. Conclusions Apatinib exhibited efficacy and an acceptable safety profile in previously heavily-treated ES-SCLC patients. Further exploration of apatinib in phase III trials is warranted. Trial registration NCT02945852.

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Section: Discussionmentioning

confidence: 99%

Apatinib in patients with extensive-stage small-cell lung cancer after second-line or third-line chemotherapy: a phase II, single-arm, multicentre, prospective study

Huang

et al. 2019

Br J Cancer

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“…One study of second-line chemotherapy in patients with a performance status of 0 or 1 gave encouraging results [23]. In this setting, a phase III trial subsequently demonstrated the superiority of oral topotecan over supportive care alone [24] and we reported that oral lomustine-cyclophosphamide-etoposide combination chemotherapy was effective and inexpensive as both second- and third-line treatment [25]. Yet the response and survival results obtained in SCLC [26] are superior to those obtained in non-SCLC, in which second, third or even subsequent lines of treatment are currently proposed.…”

Section: Discussionmentioning

confidence: 99%

Optimization of Small-Cell Lung Cancer Chemotherapy with Heparin: A Comprehensive Retrospective Study of 239 Patients Treated in a Single Specialized Center

Lebeau

Baud²,

Masanes³

et al. 2011

Chemotherapy

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Purpose: In first-line management for small-cell lung cancer (SCLC), the combination of a platinum salt and etoposide is recommended, with thoracic radiotherapy and prophylactic cranial irradiation in selected patients. Anticoagulants, including heparin, are rarely used. We analyzed the results of these different treatments in a comprehensive population of patients with SCLC. Patients and Methods: We retrospectively analyzed clinical and therapeutic characteristics of SCLC patients managed in our center during the period 1990–2002. Results: First-, second- and third-line chemotherapy was received by 98.3, 47.3 and 11.7%, respectively; 55% received curative heparin. The 2-year survival rates were 31 and 7% among patients with localized and metastatic disease, 33 and 15% among patients treated with the PCDE (cisplatin-cyclophosphamide-doxorubicin-etoposide) regimen with and without heparin, and 27 and 12% among patients treated with the PE (cisplatin or carboplatin-etoposide) regimen with and without heparin, respectively. The 2-year survival rate among the 27 patients who received an optimal combination of PCDE, heparin, thoracic radiotherapy and prophylactic cranial irradiation was 44.2%. In multivariate analysis, localized disease, younger age, use of heparin and inclusion in a clinical trial were independently associated with a better outcome. Conclusion: Despite the bias inherent in a retrospective, single-center study, these results support chemotherapy optimization for SCLC patients and confirm the value of heparin in this setting.

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“…14% of stable disease and 28% of partial response were achieved with a median TTP of 3 months [177]. Another all oral regimen with etoposide with lomustine and cyclophosphamide was used in 71 pretreated SCLC patients; ORR of 38% and severe but rare hematologic toxicity were reported [178]. An earlier trial by Correale et al with weekly cisplatin (30 mg/m 2 , days 1, 8, 14, and 28) oral etoposide (50 mg/m 2 , 1-21 of 28 days) showed increased efficacy; overall response rate was 45.2%, grade 3 leukopenia and anemia have been seen, and 3 of 31 patients died from pulmonary thromboembolism [179].…”

Section: Resultsmentioning

confidence: 99%

Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience

Şimşek

Esin

Yalçın

2019

Journal of Oncology

102

100

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Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or appending conventional maximum tolerated dose regimens, with preclinical and clinical studies for the past few decades. To date, the principle mechanisms of its action include impeding tumoral angiogenesis and modulation of hosts’ immune system, affecting directly tumor cells, their progenitors, and neighboring stromal cells. Its better toxicity profile, lower cost, and easier use are main advantages over conventional therapies. The evidence of metronomic chemotherapy for personalized medicine is growing, starting with unfit elderly patients and also for palliative treatment. The literature reviewed in this article mainly demonstrates that metronomic chemotherapy is advantageous for selected patients and for certain types of malignancies, which make it a promising therapeutic approach for filling in the gaps. More clinical studies are needed to establish a solidified role for metronomic chemotherapy with other treatment models in modern cancer management.

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Oral second- and third-line lomustine–etoposide–cyclophosphamide chemotherapy for small cell lung cancer

Cited by 23 publications

References 35 publications

Apatinib in patients with extensive-stage small-cell lung cancer after second-line or third-line chemotherapy: a phase II, single-arm, multicentre, prospective study

Apatinib in patients with extensive-stage small-cell lung cancer after second-line or third-line chemotherapy: a phase II, single-arm, multicentre, prospective study

Optimization of Small-Cell Lung Cancer Chemotherapy with Heparin: A Comprehensive Retrospective Study of 239 Patients Treated in a Single Specialized Center

Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience

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