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. 2016 Apr 1:9:1921-6.
doi: 10.2147/OTT.S101390. eCollection 2016.

Survival analysis in second-line and third-line chemotherapy with irinotecan followed by topotecan or topotecan followed by irinotecan for extensive-stage small-cell lung cancer patients: a single-center retrospective study

Gokmen Aktas  1 , Tulay Kus  1 , Mehmet Emin Kalender  1 , Alper Sevinc  1 , Celaletdin Camci  1 , Seval Kul  2
Affiliations

Survival analysis in second-line and third-line chemotherapy with irinotecan followed by topotecan or topotecan followed by irinotecan for extensive-stage small-cell lung cancer patients: a single-center retrospective study

Gokmen Aktas et al. Onco Targets Ther. .

Abstract

Purpose: The number of patients who make it to receive third-line chemotherapy is increasing owing to the improvements in adverse-event management of chemotherapy for small-cell lung cancer (SCLC). Sequencing of optimal treatment for SCLC is still a challenge for oncologists. In this paper, we aim to present a different approach to the treatment of SCLC.

Methods: Between January 2008 and July 2014, all patients diagnosed with extensive-stage SCLC and treated with third-line chemotherapy at Gaziantep University Oncology Hospital were analyzed retrospectively. Disease control rates and progression-free survival (PFS) for first-, second-, and third-line chemotherapy, and overall survival (OS) were recorded. Survival analysis was calculated by using Kaplan-Meier method.

Results: A total of 255 SCLC patients were screened, and 25 of those patients who received third-line chemotherapy were included in this study. Median age was 57±10.131 years (range: 39-74 years). Disease control rates at first-, second-, and third-line chemotherapy were 92%, 68%, and 44%, respectively. Fourteen patients received irinotecan followed by topotecan, and eleven patients received topotecan followed by irinotecan. Second-line median PFS was statistically better in patients treated with irinotecan at second-line compared with those treated with topotecan (21 vs 12 weeks, P=0.018). Comparison of third-line median PFS of the two groups was not statistically significant (14 vs 12 weeks, P=0.986). Median OS was not statistically significant in patients who received irinotecan followed by topotecan vs those who received topotecan followed by irinotecan (18 vs 14 months, P=0.112).

Conclusion: Sequential monotherapy with topotecan and irinotecan provides a considerable contribution to OS, and second-line irinotecan showed a better PFS, despite a similar OS, compared with topotecan.

Keywords: irinotecan; small-cell lung cancer; third-line chemotherapy; topotecan.

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Figures

Figure 1
Figure 1
Second-line PFS of two groups. Abbreviations: Cum, cumulative; PFS, progression-free survival; Irino-Topo, irinotecan followed by topotecan; Topo-Irino, topotecan followed by irinotecan.
Figure 2
Figure 2
Third-line PFS of two groups. Abbreviations: Cum, cumulative; PFS, progression-free survival; Irino-Topo, irinotecan followed by topotecan; Topo-Irino, topotecan followed by irinotecan.
Figure 3
Figure 3
Overall survival of two groups. Abbreviations: Cum, cumulative; Irino-Topo, irinotecan followed by topotecan; Topo-Irino, topotecan followed by irinotecan.
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