Topotecan in the Treatment of Recurrent Small Cell Lung Cancer: An Update

Author:

Ardizzoni Andrea1

Affiliation:

1. University Hospital, Parma, Italy

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Discuss the results of clinical trials of topotecan both as a single agent and in combination therapy in patients with recurrent SCLC. Describe differences in the incidences of hematologic toxicities between recurrent SCLC patients treated with lower-dose topotecan and those treated with the standard dose. Discuss the efficacy and safety of oral topotecan versus the i.v. formulation in recurrent SCLC patients. Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com Small cell lung cancer (SCLC) is an aggressive malignancy with a high propensity for early regional and distant metastasis. Response rates to first-line chemotherapy are typically high, but short lived. The outlook for patients with recurrent SCLC is poor. A variety of single- and multi-agent chemotherapy regimens have met with limited success in patients with recurrent SCLC, and survival is generally measured in weeks. Until recently, further chemotherapy was not widely considered appropriate for patients with relapsed SCLC. The choice of chemotherapy at relapse is dependent on many factors, including type of and response to first-line therapy, the treatment-free interval, and the patient's performance status. Intravenous topotecan (Hycamtin®; GlaxoSmithKline; Philadelphia, PA) has provided oncologists and patients in many countries with an effective and tolerable therapeutic option for recurrent SCLC. The clinical profile of topotecan was established in several phase II studies and confirmed in a randomized, phase III trial versus cyclophosphamide, doxorubicin (Adriamycin®; Bedford Laboratories; Bedford, OH), and vincristine (Oncovin®; Eli Lilly and Company; Indianapolis, IN)—CAV. In those studies, topotecan exhibited antitumor activity in both chemosensitive and refractory disease. Further, topotecan therapy is associated with significant symptom palliation in this patient population. Because the toxicity profile of topotecan is predictable, generally manageable, and noncumulative, the agent also has potential utility in patients with a poor prognosis and/or a poor performance status. Alternative dosing regimens (lower dose, weekly) and the introduction of an oral formulation may expand the use of topotecan as a single agent and in combination therapy in the second- and first-line treatment of this disease.

Funder

GlaxoSmithKline, Philadelphia, PA

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

Reference59 articles.

1. Global cancer statistics;Parkin;CA Cancer J Clin,1999

2. Cancer statistics, 2003;Jemal;CA Cancer J Clin,2003

3. Chemotherapy for small cell lung cancer;Sandler;Semin Oncol,2003

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3