Therapy of small cell lung cancer with emphasis on oral topotecan

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2010-10, Vol.70 (1), p.7-13
• Main Authors: Pirker, Robert, Berzinec, Peter, Brincat, Stephen, Kasan, Peter, Ostoros, Gyula, Pesek, Milos, Plāte, Signe, Purkalne, Gunta, Rooneem, Regina, Skřičková, Jana, Stanculeanu, Dana, Timcheva, Constanta, Tzekova, Valentina, Zakotnik, Branko, Zielinski, Christoph C, Zwitter, Matjaz
• Format: Article
• Language: English
• Subjects: Administration, Oral; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antineoplastic Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antiviral agents; Biological and medical sciences; Brain irradiation; Chemotherapy; Combined Modality Therapy; Hematology, Oncology and Palliative Medicine; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Medical sciences; New drugs; Pharmacology. Drug treatments; Pneumology; Pulmonary/Respiratory; Second-line therapy; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - radiotherapy; Thoracic radiotherapy; Topoisomerase I Inhibitors - administration & dosage; Topotecan; Topotecan - administration & dosage; Tumors; Tumors of the respiratory system and mediastinum
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2010.05.020

Abstract Systemic chemotherapy plays the major role in the management of patients with small cell lung cancer. Cisplatin plus etoposide is the most widely used regimen and is considered as standard in patients with limited disease. Cisplatin plus irinotecan improved survival compared to cisplatin plus etoposide in a Japanese trial but failed to do so in two trials in Caucasians. Cisplatin plus topotecan had similar efficacy compared to cisplatin plus etoposide in patients with extensive disease. In the second-line setting, topotecan showed similar efficacy but better tolerability compared to cyclophosphamide, doxorubin plus vincristine. Oral topotecan was as efficacious as its intravenous formulation and was shown to improve survival compared to best supportive care alone in patients previously treated with chemotherapy. Thus topotecan is considered as the standard second-line chemotherapy in patients with small cell lung cancer.