title: Combination of topotecan and etoposide as a salvage treatment for patients with recurrent small cell lung cancer following irinotecan and platinum first-line chemotherapy.
abstract: OBJECTIVE
  The efficacy and safety of a combined regimen of topotecan and etoposide was tested in patients with relapsed or refractory small-cell lung cancer.
  
  
  METHODS
  From October 2003 to May 2005, 23 patients who have failed to the previous irinotecan and platinum chemotherapy received intravenous topotecan 1 mg/m2 (day 1-5) and etoposide 80 mg/m2 (day 1-3). Treatment was repeated every 21 days for a maximum of 6 cycles.
  
  
  RESULTS
  Twelve patients were refractory to first-line chemotherapy. Seventeen patients (73.9%) were male and the median age was 63 years. ECOG performance status was 0-1 in 13 (56.5%) patients. The median cycles of chemotherapy was three. Twenty-one patients were assessable for response evaluation. The overall response rate was 17.4% (0 CR, 4 PR, 7 SD, 10 PD) under the intent-to-treat analysis. Two sensitive case patients and two refractory case patients achieved partial response. After a median follow-up of 20.8 months, median progression free survival was 4.7 months and median overall survival was 9.5 months. The estimated 1-year survival rate was 38.7%. All patients were assessable for toxicity and major toxicities were myelosuppression. Grade 3/4 neutropenia and thrombocytopenia occurred in 18 (78.3%) and 12 (52.2%) patients, respectively. Grade 3/4 febrile neutropenia occurred in two patients (8.7%) and infection in three patients (13.0%). There was one treatment-related death due to pneumonia.
  
  
  CONCLUSIONS
  This salvage regimen showed modest efficacy and manageable toxicities. Further study will be required in recurrent SCLC patients pretreated irinotecan and platinum.
authors.affiliation: Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seodaemun-Gu, Shinchon-Dong 134, CPO Box 8044, Seoul 120-752, South Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
authors.forename: Byoung Chul
authors.initials: BC
authors.lastname: Cho
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Shin
authors.forename: Seong Ha
authors.initials: SH
authors.lastname: Cheon
authors.forename: Jong Yul
authors.initials: JY
authors.lastname: Jung
authors.forename: Joon
authors.initials: J
authors.lastname: Chang
authors.forename: Se Kyu
authors.initials: SK
authors.lastname: Kim
authors.forename: Joo Hyuk
authors.initials: JH
authors.lastname: Sohn
authors.forename: Joo Hang
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology; D003131:Combined Modality Therapy; D023381:Endpoint Determination; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010349:Patient Compliance; D016879:Salvage Therapy; D019772:Topotecan / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D009944:Organoplatinum Compounds; D005047:Etoposide; D000077146:Irinotecan; D019772:Topotecan; D002166:Camptothecin