Chemotherapy of small cell lung cancer: state of the art

Chrystal, K.; Cheong, K. A.; Harper, Peter

doi:10.1097/00001622-200403000-00009

Cited by 26 publications

(18 citation statements)

References 25 publications

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“…The median survival for extensive stage disease (ED) is 9 -12 months, but survival after 2 years is rare (Ͻ5%) [5][6][7]. If untreated, a patient with extensive disease has a median survival of 5 weeks.…”

Section: Treatment Of Sclcmentioning

confidence: 99%

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

et al. 2007

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The hypothesis that increasing cytotoxic dose intensity will improve cancer cure rates is compelling. Although supporting evidence for this hypothesis has accrued for several tumor types, including lymphomas, breast cancer, and testicular cancers, it remains unproven. Smallcell lung cancer is extremely chemo-and radiosensitive, with a response rate of 80% achieved routinely, but few patients are cured by chemoradiotherapy. In this setting, increased cytotoxic dose intensity might improve cure rates. The finding that response rates in small-cell lung cancer correlate with received cytotoxic dose intensity merely confirms that "less is worse" and "more is better." Within conventional ranges, dose intensity can be increased with the support of hematopoietic growth factors and/or by shortening treatments intervals; however, dose intensity could be increased by only 20%-30%, and a survival advantage has not been clearly demonstrated. Given its high chemosensitivity, smallcell lung cancer was one of the first malignancies deemed suitable for increasing dose intensity and even for the use of a megadose with the support of autologous bone marrow transplantation. Some interest is emerging again due to improvements in supportive care, such as the availability of hematopoietic growth factors and peripheral blood progenitor cells. The Oncologist 2007; 12:79 -89

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Section: Treatment Of Sclcmentioning

confidence: 99%

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

et al. 2007

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“…Maintenance therapy has not been shown to be beneficial in most trials when second-line therapy is administered at the time of progression. Additionally, increased toxicity, reduction in quality of life, and decrease in subsequent response to salvage chemotherapy are often observed in patients receiving maintenance chemotherapy [27]. Furthermore, trials over the past 20 years regarding number of cycles required for optimal chemotherapy for SCLC have defined that four to six courses are standard [2].…”

Section: Prophylactic Cranial Irradiationmentioning

confidence: 99%

Management of small cell lung cancer

Ciombor

Lima

2006

Curr. Treat. Options in Oncol.

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Small cell lung cancer (SCLC) is an aggressive type of lung cancer characterized by rapid growth and early metastasis. It is chemosensitive and radiosensitive, yet decades of research investigating multimodality treatments have failed to control or cure this disease in most patients. First-line treatment of limited-stage disease consists of chemotherapy (often etoposide/cisplatin or etoposide/carboplatin) combined with thoracic radiation therapy (TRT), followed by prophylactic cranial irradiation to decrease brain metastases as a site of disease progression for those who experience complete remission or a very good partial response to multimodality treatment. In a Japanese trial, the combination of irinotecan and cisplatin had initially shown promise in treating patients with extensive-stage SCLC, but a confirmatory trial in the United States did not find a difference in overall survival with irinotecan/cisplatin versus etoposide/cisplatin. Adding a third drug to the etoposide/cisplatin combination, as well as other triplet therapies, has mostly been ineffective in improving outcomes. Variables in chemotherapy administration, including maintenance therapy, alternating non-cross-resistance regimens, and dose intensification, have not been shown to increase survival at large. In terms of radiation therapy, early administration of TRT concurrent with chemotherapy, and hyperfractionation, have been beneficial in treatment of limited-stage disease. In patients who relapse, second-line therapy options consist of reinduction of previous chemotherapy or administration of a single agent. Targeted biological therapies for SCLC are now being investigated, and although a great deal of research remains to be done, these agents and their derivatives may provide the most hope for future treatment of SCLC.

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“…Tanı anında genellikle hastalık yaygın hastalık evresindedir ve tedavisiz hastalarda ortalama sağkalım 3 ay ile sınırlıdır (3) . Sistemik bir hastalıktır ve kemosensitif bir tümördür.…”

Section: Introductionunclassified

Küçük hücreli akciğer kanseri tedavisinde ikinci hat irinotekan kemoterapisinin etkinliği

Özsarı¹,

G²

2014

Ege Tıp Dergisi

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Amaç: Küçük hücreli akciğer kanseri (KHAK), genellikle ileri evrede saptanan ve progresif seyreden bir hastalıktır. Çalışmamızın amacı ikinci hat olarak irinotekan kemoterapisi alan KHAK tanılı hastaların kemoterapi yanıtlarının ve hematolojik yan etkilerinin retrospektif olarak değerlendirilmesidir. Gereç ve Yöntem:Çalışmaya, kliniğimizde küçük hücreli akciğer kanseri tanısıyla birinci hat kemoterapiyi tamamlamış ve ardından 01.01.2009-01.01.2011 tarihleri arasında ikinci hat olarak irinotekan kemoterapisi almış, arşiv materyalinde hastalar ve tedavileri hakkında yeterli bilgi bulunan, 30-80 yaş arasında 18 hasta dahil edilmiştir. Tüm hastalar ikinci hat tedavide en azından bir kür irinotekan kemoterapisi almıştır. Veri analizi de SPSS programı kullanılarak yapılmıştır. Bulgular: 18 hasta değerlendirmeye alınmıştır. Hastaların yaş ortalaması 58.9±7.6 ve %89'unu erkek hastalar oluşturmaktadır. Birinci hat kemoterapi sonrası hastaların %78'inde yanıt sağlandığı, %6'sında ise progresyon olduğu gözlenmiştir. İrinotekan ile yapılan ikinci hat kemoterapi sonrası radyolojik değerlendirme yapıldığında hastaların sadece %17'sinde kısmi yanıt gözlendiği, %61'inde progresyon, %22'sinde stabil yanıt olduğu saptanmıştır. İrinotekan kemoterapisi ile hastaların %28'inde semptomlarda düzelme sağlanmıştır. Ortalama sağkalım tanıdan itibaren 91.2±40.2 hafta, irinotekan sonrası sağkalım 31.2±17.2 hafta ve progresyona kadar geçen süre 15.5±12.0 hafta olarak hesaplanmıştır. Hastaların %6'sına kan transfüzyonu yapılmış, %22'sinde ise en az bir kez nötropeni gözlenmiştir.Sonuç: KHAK'nin ikinci hat kemoterapisinde irinotekan verilen hastalarda kemoterapi yanıt oranları düşük olmasına karşın irinotekan kemoterapisinin kısmen tolere edilebilir olduğu gösterilmiştir.Anahtar Sözcükler: Küçük hücreli akciğer kanseri, irinotekan, sağkalım. Summary Aim: Small cell lung cancer (SCLC) is a progressive and advanced disease. The purpose of this study is to evaluate the response and the hematological side effects of irinotecan chemotherapy in patients with SCLC retrospectively. Materials and Methods: Eighteen patients were included in our study who were between the ages of 30-80 years, had a diagnosis for SCLC, had completed first-line chemotherapy and had taken second-line irinotecan

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Chemotherapy of small cell lung cancer: state of the art

Abstract: Small cell lung cancer remains an aggressive disease. Recent advances have yielded, at best, only modest gains. New strategies are required, including incorporation of novel targeted agents.

Cited by 26 publications

References 25 publications

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

Increasing Chemotherapy in Small-Cell Lung Cancer: From Dose Intensity and Density to Megadoses

Management of small cell lung cancer

Küçük hücreli akciğer kanseri tedavisinde ikinci hat irinotekan kemoterapisinin etkinliği

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