Real‐life second‐line epirubicin–paclitaxel regimen as treatment of relapsed small‐cell lung cancer: EpiTax study

Abstract

Background Few therapeutic options are approved as second‐line treatment after failure of platinum‐based chemotherapy for patients with extensive‐stage small‐cell lung cancer (ES‐SCLC). Topotecan widespread use remains challenged by the risk of severe toxicities in a pretreated population. Little is known about the efficacy and safety of epirubicin–paclitaxel doublet in second‐line and beyond and especially cerebral outcomes. Methods EpiTax is a retrospective multicenter observational real‐life study. We evaluated the efficacy of epirubicin 90 mg/m 2 combined with paclitaxel 175 mg/m 2 every 3 weeks in SCLC patients after failure of at least one line of platinum‐based chemotherapy. The primary endpoint was progression‐free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), intracranial control rate (ICR), and safety. Results A total of 29 patients were included. The median of previous systemic therapy lines was 2 (1–4). Eleven patients received the treatment in the second line. Characteristics of patients were a median age of 60 years (45–77), 65.5% of males with 72.4% of PS 0–1. Fifteen patients had a history of brain metastases. Median PFS and OS achieved 11.0 (95% CI, 8.1–16.3) and 23 (95% CI, 14.1–29.6) weeks, respectively. ORR was 34.5% and DCR was 55.2%. ICR was 3/15 (20%). Grade 3–4 adverse events were mainly hematological and concerned 7 patients. No case of febrile neutropenia or toxic death was reported. Conclusion Epirubicin–paclitaxel association highlighted promising efficacy with PFS and OS of 11 and 23 weeks, respectively, ORR of 34.5%, and a tolerable safety profile. This doublet could represent another valuable therapeutic option for ES‐SCLC patients treated in the second line and beyond.

Chemotherapeutic and targeted drugs-induced immunogenic cell death in cancer models and antitumor therapy: An update review

“…Epirubicin, a type of anthracycline, interferes with DNA and RNA synthesis, and can be combined with other chemotherapeutic drugs to treat various malignant tumors, including postoperative lung cancer and breast cancer (Cameron et al, 2017;Annic et al, 2022;Schneeweiss et al, 2022). In addition, Li et al engineered a selfamplified biomimetic nanosystem, in which epirubicin, glucose oxidase, and hemin are encapsulated within the core of ZIF-8 nanoparticles, which significantly induced ICD to promote DC maturation and CTL infiltration into tumor lesions (Li et al, 2023).…”

Entinostat Enhances the Efficacy of Chemotherapy in Small Cell Lung Cancer Through S-phase Arrest and Decreased Base Excision Repair

“… 6–9 ). Additionally, epirubicin is of therapeutic interest and has been investigated in several clinical trials in SCLC ( 10 ).…”

Mechanism of Taxanes in the Treatment of Lung Cancer Based on Network Pharmacology and Molecular Docking

“…Some taxanes, such as 10-deacetylbaccatin III (10-DAB III), can be used as raw materials for semi-synthetic paclitaxel, while others, such as docetaxel, 7-xylosyl-10-deacetyltaxol (7-Xyl-10-DAT), and so on, have various pharmacological activities [ 13 , 14 ]. Paclitaxel is used to treat SCLC, for example, Annic et al’s research shows that epirubicin combined with paclitaxel can be used to treat SCLC after platinum chemotherapy failure [ 15 ]. Wang et al shows that nanoparticle albumin combined with paclitaxel is safe and effective in the third-line treatment of recurrent SCLC [ 16 ], and Eiff et al’s research shows that paclitaxel has clinically relevant activity in heavily pretreated SCLC [ 17 ].…”