Schmittel Alexander, Knödler Maren, Hortig Patricia, Schulze Karsten, Thiel Eckhard, Keilholz Ulrich
Medizinische Klinik III (Hämatologie, Onkologie und Transfusionsmedizin), Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
Lung Cancer. 2007 Jan;55(1):109-13. doi: 10.1016/j.lungcan.2006.09.029. Epub 2006 Nov 13.
The efficacy and toxicity of bendamustine chemotherapy in relapsed small cell lung cancer (SCLC) was determined in this phase II trial.
Patients with cytologically or histologically proven SCLC, who had a sensitive relapse, which was defined as a relapse>or=2 months after completion of primary therapy, were eligible for this study. After informed consent patients received 120 mg/m2 of bendamustine on Days 1 and 2 every 3 weeks. A maximum of six cycles was administered. Primary endpoint was response rate, secondary endpoints included toxicity, progression free survival and overall survival (OS).
Twenty-one patients with a median age of 59 years (range 47-76) were accrued to this trial. Six (29%) of 21 patients achieved a confirmed partial remission, 6 (29%) had stable disease and 9 (42%) patients progressed according to RECIST criteria. Median progression free survival was 4 months (95% CI 0-8, 3), median overall survival was 7 months (95% CI 5, 8-8, 2). One- and 2-year survival was 16% and 8%, respectively. Grade III/IV neutropenia occurred in 3 (15%) of 21 patients, 1 patient had a lethal Gram-negative sepsis in neutropenia. Two additional patients had pneumonia in the absence of neutropenia. Two patients (10%) had a grade III anemia, no grade III or IV thrombocytopenia was observed.
This trial demonstrates efficacy of bendamustine in relapsed SCLC and a favourable toxicity profile. Therefore, single-agent bendamustine is a treatment option for patients with SCLC, who have responded to initial platinum containing chemotherapy and should further be investigated in randomized trials.
在这项II期试验中确定苯达莫司汀化疗对复发小细胞肺癌(SCLC)的疗效和毒性。
细胞学或组织学确诊为SCLC且出现敏感复发(定义为在完成初始治疗后≥2个月复发)的患者符合本研究条件。在获得知情同意后,患者每3周的第1天和第2天接受120mg/m²苯达莫司汀治疗。最多给予6个周期。主要终点为缓解率,次要终点包括毒性、无进展生存期和总生存期(OS)。
21例患者纳入本试验,中位年龄59岁(范围47 - 76岁)。根据RECIST标准,21例患者中有6例(29%)达到确认的部分缓解,6例(29%)疾病稳定,9例(42%)患者病情进展。中位无进展生存期为4个月(95%CI 0 - 8, 3),中位总生存期为7个月(95%CI 5, 8 - 8, 2)。1年和2年生存率分别为16%和8%。21例患者中有3例(15%)发生III/IV级中性粒细胞减少,1例患者在中性粒细胞减少时发生致命的革兰氏阴性菌败血症。另外2例患者在无中性粒细胞减少的情况下发生肺炎。2例患者(10%)出现III级贫血,未观察到III级或IV级血小板减少。
本试验证明了苯达莫司汀对复发SCLC的疗效及良好的毒性特征。因此,单药苯达莫司汀是对含铂初始化疗有反应的SCLC患者的一种治疗选择,应在随机试验中进一步研究。