Yılmaz Feride, Yaşar Serkan, Tatar Ömer Denizhan, Yıldırım Hasan Çağrı, Güven Deniz Can, Akyıldız Arif, Chalabiyev Elvin, Aktaş Burak Yasin, Arık Zafer, Erman Mustafa
Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Türkiye.
Department of Internal Medicine, Türkeli State Hospital, Sinop, Türkiye.
BMC Cancer. 2024 Oct 1;24(1):1218. doi: 10.1186/s12885-024-12935-x.
Despite initial dramatic responses, metastatic small cell lung cancer (SCLC) invariably recurs. Irinotecan is one of the active agents for patients with recurrent SCLC. In the second line, weekly or three-weekly irinotecan regimens have been adopted, however, the optimal dose and schedule is not defined. In our institution, we use a bi-weekly regimen of irinotecan. In this study, we aimed to investigate the safety and efficacy of the bi-weekly irinotecan in the second- or third-line treatment of SCLC patients.
The study population consisted of advanced stage SCLC patients who were followed at Hacettepe University Cancer Institute between January 2007 and March 2021 and received salvage irinotecan 180 mg/m every two weeks, following progression after platinum-etoposide treatment.
One hundred patients were included. At diagnosis, nineteen patients (19%) had limited stage and 81 patients (81%) had extensive stage SCLC. Objective response rates (ORR) were 44.6% and 46.2% for patients who received irinotecan treatment in second line, and in third line, respectively. Seventeen percent of all the patients had grade 3 and above adverse events during irinotecan treatment. In our study, 45.8% of patients were able to complete at least 6 cycles of irinotecan treatment and 69.8% were able to receive at least 3 cycles of irinotecan treatment without any dose interruption or reduction.
Irinotecan 180 mg/m every two weeks appears to be safe and effective in the 2nd- and 3rd-line treatment of advanced stage SCLC. Bi-weekly administration allows G-CSF prophylaxis in between doses, leading to an uninterrupted administration.
尽管转移性小细胞肺癌（SCLC）患者最初对治疗有显著反应，但几乎总会复发。伊立替康是复发性SCLC患者的有效治疗药物之一。在二线治疗中，已采用每周或每三周一次的伊立替康治疗方案，然而，最佳剂量和给药方案尚未确定。在我们机构，我们使用每两周一次的伊立替康治疗方案。在本研究中，我们旨在探讨每两周一次伊立替康在SCLC患者二线或三线治疗中的安全性和疗效。
研究人群包括2007年1月至2021年3月在哈杰泰佩大学癌症研究所随访的晚期SCLC患者，这些患者在接受铂类-依托泊苷治疗进展后，每两周接受180mg/m²的挽救性伊立替康治疗。
共纳入100例患者。诊断时，19例患者（19%）为局限期，81例患者（81%）为广泛期SCLC。接受二线和三线伊立替康治疗的患者的客观缓解率（ORR）分别为44.6%和46.2%。在伊立替康治疗期间，所有患者中有17%发生3级及以上不良事件。在我们的研究中，45.8%的患者能够完成至少6个周期的伊立替康治疗，69.8%的患者能够接受至少3个周期的伊立替康治疗，且无任何剂量中断或减少。
每两周一次给予180mg/m²伊立替康在晚期SCLC的二线和三线治疗中似乎是安全有效的。每两周给药一次可在两次给药之间进行粒细胞集落刺激因子（G-CSF）预防，从而实现不间断给药。
