Current and Emerging Pharmacotherapies for the Treatment of Relapsed Small Cell Lung Cancer

Nair, Binu; Bhanderi, Vipul; Jafri, Syed Hasan Raza

doi:10.4137/cmo.s5964

Cited by 11 publications

(10 citation statements)

References 61 publications

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“…In patients with refractory disease, response rates to second-line therapy are less than 10%, and the median OS from the start of a second-line therapy is 4 months. Response rates to combination chemotherapy are higher than those to a single agent; however, the reported response rates are variable, reflecting the population heterogeneity [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

A Phase II Study of Weekly Paclitaxel Plus Gemcitabine as a Second-Line Therapy in Patients with Metastatic or Recurrent Small Cell Lung Cancer

et al. 2016

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PurposePaclitaxel (P) and gemcitabine (G) are clinically synergistic in small cell lung cancer (SCLC). We evaluated the efficacy of PG as a salvage treatment for SCLC patients whose disease progressed after a platinum-containing regimen.Materials and MethodsEligibility included histologically confirmed SCLC, one dimensionally measurable disease, Eastern Cooperative Oncology Group performance status 0-2, and progressive disease after platinum-based chemotherapy. Treatment consisted of P (80 mg/m2) and G (1,000 mg/m2) on days 1 and 8 of each cycle of 21 days until disease progression.ResultsThirty-three patients seen between December 2005 and February 2009 were selected into this study. Thirty patients (91%) had received irinotecan-platinum, and three had received etoposide-platinum. Sixteen patients (49%) had a treatment-free interval of less than 3 months. The overall response rate was 30.3% (29.4% in sensitive relapse and 31.3% in refractory relapse). The median time to progression was 12.0 weeks and median overall survival (OS) 31.0 weeks, with a 1-year OS rate of 30.3%. Toxicities were moderate and manageable with 18.2% grade (G) 4 neutropenia, 24.2% G3 thrombocytopenia, 6.1% G3 sensory neuropathy, and 3% G3 asthenia. One patient developed febrile neutropenia.ConclusionSecond-line paclitaxel and gemcitabine were well-tolerated and moderately active in SCLC patients previously treated with platinum-based chemotherapy.

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Section: Discussionmentioning

confidence: 99%

A Phase II Study of Weekly Paclitaxel Plus Gemcitabine as a Second-Line Therapy in Patients with Metastatic or Recurrent Small Cell Lung Cancer

et al. 2016

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“…In a small study, the ECb and EC combinations were compared, and the researchers reported the equivalence of the two treatments, although ECb was found to be less toxic 13. A number of studies with paclitaxel as monotherapy or as part of combination regimens have been evaluated with inconsistent results in first- and second-line treatment 14,15…”

Section: Discussionmentioning

confidence: 99%

The role of second-line chemotherapy in small cell lung cancer: a retrospective analysis

Zarogoulidis¹,

Boutsikou²,

Darwiche³

et al. 2013

OTT

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BackgroundTo evaluate the benefit of second-line chemotherapy with platinum-based treatment in patients with recurrent small cell lung cancer (SCLC).Patients and methodsA total of 535 patients continued with follow-up or best supportive care if needed, and 229 patients who progressed after the completion of first-line chemotherapy were treated with second-line chemotherapy at the time of progression. In total, 103/229 patients received paclitaxel 190 mg/m2 and carboplatin 5.5 area under the curve while 126/229 patients received etoposide 200 mg/m2 and carboplatin 5.5 area under the curve every 28 days.ResultsPatients administered second-line chemotherapy lived significantly longer, with a median survival of 422 days compared to 228 days in patients with best supportive care alone (P<0.001). Patients who received paclitaxel as second-line chemotherapy lived for an average of 462 days (95% confidence interval: 409–514), versus 405 days in the etoposide group (95% confidence interval: 371–438), which was not statistically significant (P=0.086). The overall response rate was 8% for the paclitaxel group and 6% for the etoposide group. Patients with progression of the disease in more than 3 months had significantly better survival compared with those that progressed in less than 3 months (P<0.001).ConclusionContinuation with carboplatin/paclitaxel or carboplatin/etoposide as second-line chemotherapy has no significant survival impact, and it did not improve response rates.

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“…A new experimental treatment has recently been explored. Picoplatin, which is a new platinum compound created to surmount other platinum agents, has already exhibited decreased neurotoxicity and nephrotoxicity than other platinum compounds (Nair et al, 2011). However, the study reported that the picoplatin did not exhibit any improvements in overall survival rate when compared to other chemotherapeutic agents (Eckardt et al, 2009).…”

Section: Overcoming Drug Resistancementioning

confidence: 99%

Erlotinib Resistance in Lung Cancer: Current Progress and Future Perspectives

Tang¹,

Salama²,

Gadgeel³

et al. 2013

Front. Pharmacol.

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Lung cancer is the most common cancer in the world. Despite modern advancements in surgeries, chemotherapies, and radiotherapies over the past few years, lung cancer still remains a very difficult disease to treat. This has left the death rate from lung cancer victims largely unchanged throughout the past few decades. A key cause for the high mortality rate is the drug resistance that builds up for patients being currently treated with the chemotherapeutic agents. Although certain chemotherapeutic agents may initially effectively treat lung cancer patients, there is a high probability that there will be a reoccurrence of the cancer after the patient develops resistance to the drug. Erlotinib, the epidermal growth factor receptor (EGFR)-targeting tyrosine kinase inhibitor, has been approved for localized as well as metastatic non-small cell lung cancer where it seems to be more effective in patients with EGFR mutations. Resistance to erlotinib is a common observation in clinics and this review details our current knowledge on the subject. We discuss the causes of such resistance as well as innovative research to overcome it. Evidently, new chemotherapy strategies are desperately needed in order to better treat lung cancer patients. Current research is investigating alternative treatment plans to enhance the chemotherapy that is already offered. Better insight into the molecular mechanisms behind combination therapy pathways and even single molecular pathways may help improve the efficacy of the current treatment options.

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Current and Emerging Pharmacotherapies for the Treatment of Relapsed Small Cell Lung Cancer

Cited by 11 publications

References 61 publications

A Phase II Study of Weekly Paclitaxel Plus Gemcitabine as a Second-Line Therapy in Patients with Metastatic or Recurrent Small Cell Lung Cancer

A Phase II Study of Weekly Paclitaxel Plus Gemcitabine as a Second-Line Therapy in Patients with Metastatic or Recurrent Small Cell Lung Cancer

The role of second-line chemotherapy in small cell lung cancer: a retrospective analysis

Erlotinib Resistance in Lung Cancer: Current Progress and Future Perspectives

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