Topotecan for Relapsed Small-cell Lung Cancer: Systematic Review and Meta-Analysis of 1347 Patients.
Topotecan is the most reliable chemotherapy regimen for relapsed small-cell lung carcinoma (SCLC). The efficacy and adverse effects of topotecan as reported by previous studies varied greatly. The inclusion criterion was a prospective study that was able to provide data for 6-month over-all survival (OS) rate, 1-year OS rate, objective responses, and/or adverse effects of single agent topotecan as a second line chemotherapy for SCLC, written in English language as a full article. Any topotecan regimen were allowed. Binary data were meta-analyzed with the random-model generic inverse variance method. We included 14 articles consisted of 1347 patients. Pooled values were estimated as follows. <Refractory relapse> Six-month OS rate: 37% (95% CI: 28-46%). One-year OS rate: 9% (95% CI: 5-13%). Response rate: 5% (95% CI: 1-8%). <Sensitive relapse> Six-month OS rate: 57% (95% CI: 50-64%). One-year OS rate: 27% (95% CI: 22-32%). Response rate: 17% (95% CI: 11-23%). <Adverse effect> Grade III/IV neutropenia 69% (95% CI: 58-80%). Grade III/IV thrombopenia 41% (95% CI: 34-48%). Grade III/IV anemia 24% (95% CI: 17-30%). Non-hematorogical events were rare. Chemotherapy-related death 2% (95% CI: 1-3%). In conclusion, Topotecan provided a possibly promising outcome for sensitive-relapse SCLC and poor outcome for refractory relapse SCLC. Adverse events were mainly hematological.
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Nobuyuki
N
Horita
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Masaki
M
Yamamoto
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Takashi
T
Sato
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Toshinori
T
Tsukahara
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hideyuki
H
Nagakura
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Ken
K
Tashiro
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Yuji
Y
Shibata
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hiroki
H
Watanabe
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kenjiro
K
Nagai
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Miyo
M
Inoue
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kentaro
K
Nakashima
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Ryota
R
Ushio
Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan.
Masaharu
M
Shinkai
Respiratory Disease Center, Yokohama City University Medical Center, Yokohama, Japan.
Makoto
M
Kudo
Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Takeshi
T
Kaneko
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D019772:Topotecan / Q000009:adverse effects / Q000627:therapeutic use*
D019772:Topotecan