Randomized phase III trial of amrubicin versus topotecan as second-line treatment for patients with small-cell lung cancer.
OBJECTIVE
Amrubicin, a third-generation anthracycline and potent topoisomerase II inhibitor, showed promising activity in small-cell lung cancer (SCLC) in phase II trials. This phase III trial compared the safety and efficacy of amrubicin versus topotecan as second-line treatment for SCLC.


METHODS
A total of 637 patients with refractory or sensitive SCLC were randomly assigned at a ratio of 2:1 to 21-day cycles of amrubicin 40 mg/m(2) intravenously (IV) on days 1 to 3 or topotecan 1.5 mg/m(2) IV on days 1 to 5. Primary end point was overall survival (OS); secondary end points included overall response rate (ORR), progression-free survival (PFS), and safety.


RESULTS
Median OS was 7.5 months with amrubicin versus 7.8 months with topotecan (hazard ratio [HR], 0.880; P = .170); in refractory patients, median OS was 6.2 and 5.7 months, respectively (HR, 0.77; P = .047). Median PFS was 4.1 months with amrubicin and 3.5 months with topotecan (HR, 0.802; P = .018). ORR was 31.1% with amrubicin and 16.9% with topotecan (odds ratio, 2.223; P < .001). Grade ≥ 3 treatment-emergent adverse events in the amrubicin and topotecan arms were: neutropenia (41% v 54%; P = .004), thrombocytopenia (21% v 54%; P < .001), anemia (16% v 31%; P < .001), infections (16% v 10%; P = .043), febrile neutropenia (10% v 3%; P = .003), and cardiac disorders (5% v 5%; P = .759); transfusion rates were 32% and 53% (P < .001), respectively. NQO1 polymorphisms did not influence safety outcomes.


CONCLUSIONS
Amrubicin did not improve survival when compared with topotecan in the second-line treatment of patients with SCLC. OS did not differ significantly between treatment groups, although an improvement in OS was noted in patients with refractory disease treated with amrubicin.
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ. j.pawel@asklepios.com.
Joachim
J
von Pawel
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Robert
R
Jotte
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
David R
DR
Spigel
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Mary E R
ME
O'Brien
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Mark A
MA
Socinski
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Jörg
J
Mezger
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Martin
M
Steins
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Léon
L
Bosquée
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Jeffrey
J
Bubis
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Kristiaan
K
Nackaerts
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
José M
JM
Trigo
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Philip
P
Clingan
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Wolfgang
W
Schütte
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Paul
P
Lorigan
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Martin
M
Reck
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Manuel
M
Domine
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Frances A
FA
Shepherd
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Shaoyi
S
Li
Joachim von Pawel, Asklepios Fachkliniken München-Gauting, Gauting; Jörg Mezger, St Vincentius-Kliniken Karlsruhe, Karlsruhe; Martin Steins, Thoraxklinik am Universitätsklinikum, Heidelberg; Wolfgang Schütte, Krankenhaus Martha-Maria Halle-Dölau, Halle; Martin Reck, Krankenhaus Großhansdorf, Großhansdorf, Germany; Robert Jotte, Rocky Mountain Cancer Center, Denver, CO, and US Oncology, Houston, TX; David R. Spigel, Sarah Cannon Research Institute, Nashville, TN; Mary E.R. O'Brien, Royal Marsden National Health Service (NHS) Foundation Trust, Surrey; Paul Lorigan, Christie NHS Foundation Trust, Manchester, United Kingdom; Mark A. Socinski, University of Pittsburgh Medical Center, Pittsburgh, PA; Léon Bosquée, Centre Hospitalier Universitaire Sart-Tilman, Liège; Kristiaan Nackaerts, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium; Jeffrey Bubis, Cancer Specialists of North Florida, Jacksonville, FL; José M. Trigo, Hospital Universitario Virgen de la Victoria, Malaga; Manuel Domine, Fundación Jiménez Diaz, Universidad Autónoma de Madrid, Madrid, Spain; Philip Clingan, Southern Medical Day Care Centre, Wollongong, New South Wales, Australia; Frances A. Shepherd, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Shaoyi Li and Markus F. Renschler, Celgene, Summit, NJ.
Markus F
MF
Renschler
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D005838:Genotype; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016660:NAD(P)H Dehydrogenase (Quinone) / Q000235:genetics; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide; D016016:Proportional Hazards Models; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality; D019772:Topotecan / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D018943:Anthracyclines; D000970:Antineoplastic Agents; D019772:Topotecan; C055866:amrubicin; D016660:NAD(P)H Dehydrogenase (Quinone); C447479:NQO1 protein, human