Temozolomide as Potential Second-Line Option for Patients With Small Cell Lung Cancer
According to results from a retrospective analysis, second-line temozolomide, an oral alkylating agent, demonstrated promise among patients with small cell lung cancer (SCLC).
“Despite initial responsiveness to first-line platinum-etoposide chemotherapy, most patients relapse within 6 months,” stated Sofie Dhaeyer, Ghent University Hospital, Ghent, Belgium, and coauthors. “Managing disease progression, particularly in platinum-resistant or refractory cases, remains challenging.”
This real-world cohort included 47 pretreated patients with relapsed SCLC who received 250 mg of once daily temozolomide on days 1 through 5 of every 28-day cycle between February 2011 and March 2023 at a single academic hospital in Belgium. Among the data analyzed were overall response rate (ORR), disease control rate, progression-free survival (PFS), overall survival (OS), and safety.
At analysis, ORR was 14.9% and disease control rate was 23.4%. Median PFS was 1.7 months, and median OS was 3.2 months. Grade 3/4 treatment-related adverse events were observed in 34% of patients.
“Temozolomide demonstrated modest clinical activity in this real-world effectiveness analysis of patients with relapsed SCLC,” concluded Dr Dhaeyer et al. “Nevertheless, given its comparable response rate and milder toxicity profile compared to topotecan, temozolomide should be considered as a viable alternative to topotecan for treating relapsed SCLC.”
Source:
Dhaeyer S, Missault E, Surmont V, et al. Outcome of temozolomide in relapsed small cell lung cancer: A retrospective single center analysis. Lung Cancer. Published online: April 13, 2025. doi: 10.1016/j.lungcan.2025.108539
