title: The efficacy of amrubicin on central nervous system metastases originating from small-cell lung cancer: a case series of eight patients.
abstract: BACKGROUND
  Central nervous system (CNS) metastases caused by small-cell lung cancer (SCLC) are incurable and therefore fatal. Although such metastases are usually treated with chemotherapy or radiotherapy, their sensitivity to these treatment measures is unclear. Amrubicin appears to be a promising agent for relapsed SCLC, but its effectiveness in CNS metastases originating from SCLC is unknown.
  
  
  METHODS
  Between April 2002 and December 2009, 110 SCLC patients with CNS metastasis were treated at Shizuoka Cancer Center. Of these, we retrospectively reviewed 8 consecutive cases with CNS metastases originating from relapsed SCLC that were treated with amrubicin as a second-line therapy.
  
  
  RESULTS
  We recorded three sensitive relapses and five refractory cases. Amrubicin yielded a CNS response rate of 50 % (2 partial responses and 2 complete response; 95 % CI, 21.5-78.5\ %) and the disease control rate for CNS lesions was 87.5 % (95 % CI, 52.9-97.8 %). All of the sensitive relapse patients achieved a partial response. The median time to progression for CNS metastases was 150.5 days (95 % CI, 9-171 days), and the median survival time from the start of amrubicin administration was 230.5 days (95 % CI, 89-619 days). We also report a dramatic improvement in one patient's radiological result of intramedullary spinal cord metastasis and alleviation of her symptoms following amrubicin monotherapy including this case series.
  
  
  CONCLUSIONS
  The results of this study suggest that amrubicin is active in patients with CNS metastases originating from SCLC.
authors.affiliation: Department of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan, miusat1118@med.niigata-u.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Miura
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kaira
authors.forename: Rieko
authors.initials: R
authors.lastname: Kaira
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Akamatsu
authors.forename: Akira
authors.initials: A
authors.lastname: Ono
authors.forename: Takehito
authors.initials: T
authors.lastname: Shukuya
authors.forename: Asuka
authors.initials: A
authors.lastname: Tsuya
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kenmotsu
authors.forename: Tateaki
authors.initials: T
authors.lastname: Naito
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Murakami
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055752:Small Cell Lung Carcinoma / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines; D003287:Contrast Media; C055866:amrubicin
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