A regimen containing cisplatin, etoposide, and irinotecan may be clinically beneficial as a second-line treatment for certain patients with small cell lung cancer, according to a clinical trial conducted in Japan.
For the trial, investigators led by Koichi Goto, MD, National Cancer Center Hospital East, Chiba, Japan, enrolled 180 patients with small cell lung cancer that had responded to first-line treatment, but later exhibited evidence of relapse or progression after at least 90 days of treatment completion. These participants were randomly assigned to receive a combination of chemotherapy with cisplatin plus etoposide plus irinotecan (n=90) or topotecan monotherapy (n=90). They published their results in The Lancet Oncology.
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At a median follow-up of 22.7 months, overall survival was found to be significantly longer in the group receiving the combination regimen than in those only treated with topotecan (median 18.2 months vs 12.5 months, respectively). Combination chemotherapy with cisplatin plus etoposide and irinotecan also reduced the risk of death by more than 30% when compared with the topotecan group.
However, the rate of adverse events did vary based on whether combination chemotherapy or topotecan monotherapy was received, with the most common grade 3 to 4 events being neutropenia (75 patients [85%] vs 77 patients [86%], respectively), anemia (76 patients [84%] vs 25 patients [28%]), and leucopenia (72 patients [80%] vs 46 patients [51%]). Serious adverse events were reported in 4% and 10% of patients in the topotecan and combination arms, respectively. Treatment-related deaths occurred in two patients receiving topotecan and 1 patient receiving the combination regimen.
From these results, investigators concluded that combination chemotherapy with cisplatin plus etoposide plus irinotecan could be considered the standard second-line chemotherapy for specified patients with sensitive relapsed small cell lung cancer.
