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Impact of Amrubicin Monotherapy as Second-Line Chemotherapy on Outcomes in Elderly Patients with Relapsed Extensive-Disease Small-Cell Lung Cancer

Authors Igawa S, Ono T, Kasajima M, Manabe H, Fukui T, Mitsufuji H, Yokoba M, Kubota M, Katagiri M, Sasaki J, Naoki K

Received 26 March 2020

Accepted for publication 9 June 2020

Published 23 June 2020 Volume 2020:12 Pages 4911—4921


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Ahmet Emre Eskazan

Satoshi Igawa,1 Taihei Ono,1 Masashi Kasajima,1 Hideaki Manabe,1 Tomoya Fukui,1 Hisashi Mitsufuji,2 Masanori Yokoba,3 Masaru Kubota,3 Masato Katagiri,3 Jiichiro Sasaki,4 Katsuhiko Naoki1

1Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara-City, Kanagawa 252-0374, Japan; 2Kitasato University School of Nursing, Sagamihara-City, Kanagawa 252-0329, Japan; 3School of Allied Health Sciences, Kitasato University, Sagamihara-City, Kanagawa 252-0373, Japan; 4Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara-City, Kanagawa 252-0374, Japan

Correspondence: Satoshi Igawa
Department of Respiratory Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-Ku, Sagamihara-City, Kanagawa 252-0374, Japan
Tel +81 42 778 8506
Fax +81 42 778 6412

Purpose: Amrubicin (AMR) is an anticancer drug for patients with relapsed small-cell lung cancer (SCLC). However, the efficacy of AMR in elderly patients with relapsed SCLC after chemotherapy by carboplatin plus etoposide (CE) has not been sufficiently evaluated.
Patients and Methods: The medical records of patients with relapsed SCLC who received AMR as second-line chemotherapy were retrospectively reviewed, and their treatment outcomes were evaluated.
Results: Forty-one patients with a median age of 76 years were analyzed. The overall response rate was 26.8%. Median progression-free survival (PFS) and overall survival (OS) were 3.5 and 8.1 months, respectively. While the median PFS of 4.7 and 2.8 months in the sensitive relapse and the refractory relapse group differed significantly (P=0.043), respectively, the median OS of 10.7 and 6.8 months in the respective relapse groups did not indicate a statistically significant difference (P=0.24). The median PFS in a group with a modified Glasgow prognostic score (mGPS) of 0 and a group with a mGPS 1 or 2 were 4.5 and 1.6 months (P=0.052), respectively, and the median OS in the respective mGPS groups were 10.7 and 4.4 months (P=0.034). Multivariate analysis identified good performance status, limited disease, and mGPS 0 as favorable independent predictors of PFS and OS of AMR monotherapy. Grade 3 or higher neutropenia was observed in 23 patients (56%), and febrile neutropenia was observed in nine patients (22%). Non-hematological toxic effects were relatively mild, and pneumonitis and treatment-related deaths were not observed.
Conclusion: AMR is an effective and feasible regimen for elderly patients with relapsed SCLC after CE therapy.

Keywords: small-cell lung cancer, amrubicin, elderly, second-line chemotherapy, modified Glasgow prognostic score

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