title: Low-dose irinotecan as a second-line chemotherapy for recurrent small cell lung cancer.
abstract: OBJECTIVE
  Irinotecan is a potent inhibitor of deoxyribonucleic acid topoisomerase 1 and the weekly schedule of 100-125 or 350 mg/m(2) administration on Day 1 every 3 weeks is recommended for recurrent small cell lung cancer. However, severe gastrointestinal toxic effects and myelosuppression are often observed in this dose setting. We conducted a retrospective study to evaluate the efficacy and safety of low-dose irinotecan monotherapy (60 mg/m(2) on Days 1, 8 and 15 every 4 weeks) as second-line chemotherapy for small cell lung cancer.
  
  
  METHODS
  The medical charts of small cell lung cancer patients who had received second-line chemotherapy at the National Cancer Center Hospital East between April 2003 and June 2012 were reviewed. Consecutive 57 patients who were treated with low dose of irinotecan (60 mg/m(2) on Days 1, 8 and 15 every 4 weeks) were analyzed in this study.
  
  
  RESULTS
  Median age was 70 years (range, 51-83). Fifty-two (91%) were male, 36 (63%) had an Eastern Cooperative Oncology Group performance status 0-1 and 26 (46%) were sensitive relapse. The median number of chemotherapy cycles was 2. The objective response rate was 32% (95% confidence interval: 20-45%).The median progression-free survival and the median overall survival were 2.9 months (95% confidence interval: 1.9-3.4 months) and 5.3 months (95% confidence interval: 3.6-7.6 months), respectively. The incidence of Grade 3/4 neutropenia, diarrhea and nausea/vomiting was 21, 4 and 5%, respectively.
  
  
  CONCLUSIONS
  Low-dose irinotecan monotherapy for recurrent small cell lung cancer might be effective with favorable toxicity. Randomized trial of 60 mg/m(2) versus standard dose of irinotecan is warranted.
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Masahiro
authors: M
authors: Morise
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan shiniho@east.ncc.go.jp.
authors: Seiji
authors: S
authors: Niho
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Shigeki
authors: S
authors: Umemura
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Shingo
authors: S
authors: Matsumoto
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Kiyotaka
authors: K
authors: Yoh
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Koichi
authors: K
authors: Goto
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Hironobu
authors: H
authors: Ohmatsu
authors: Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Yuichiro
authors: Y
authors: Ohe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D002166:Camptothecin
keywords: irinotecan; refractory relapse; second-line; sensitive relapse; small cell lung cancer