Paclitaxel for treatment of advanced small cell lung cancer (SCLC): a retrospective study of 185 patients
Background: Etoposide-/platinum-based chemotherapy is the standard first-line treatment for extensive- disease small cell lung cancer (SCLC), but responses are short-lived and subsequent options limited. Here, we present our experience with paclitaxel in advanced treatment lines. - Methods: We re...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[2020]
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| In: |
Journal of thoracic disease
Year: 2020, Volume: 12, Issue: 3, Pages: 782-793 |
| ISSN: | 2077-6624 |
| DOI: | 10.21037/jtd.2019.12.74 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.21037/jtd.2019.12.74 Verlag, kostenfrei, Volltext: http://jtd.amegroups.com/article/view/35170 
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| Author Notes: | Damian von Eiff, Farastuk Bozorgmehr, Inn Chung, Denise Bernhardt, Stefan Rieken, Stephan Liersch, Thomas Muley, Sonja Kobinger, Michael Thomas, Petros Christopoulos, Martin Steins |
| Summary: | Background: Etoposide-/platinum-based chemotherapy is the standard first-line treatment for extensive- disease small cell lung cancer (SCLC), but responses are short-lived and subsequent options limited. Here, we present our experience with paclitaxel in advanced treatment lines. - Methods: We retrospectively studied the clinical course of all paclitaxel-treated SCLC patients between 2005 and 2015 in our institution. Prognostic and predictive factors were analyzed by Kaplan-Meier and Cox regression analyses. - Results: A total of 185 patients [119 men, median age 65 years, median ECOG performance status (PS) 1] were identified. One hundred and sixty-eight patients had extensive disease (ED) at the time of paclitaxel therapy. Paclitaxel was mainly given as third- or fourth-line therapy (93%). The response rate (RR) was 17% and disease control rate (DCR) 28%. Patients reached a median progression-free survival (PFS) of 1.6 (95% CI: 1.4-1.8) months and median overall survival (OS) of 3.3 (95% CI: 2.8-3.9) months. Main toxicities were fatigue (25%) and polyneuropathy (17%). Dose reduction of ≥25% was associated with shorter PFS [1.9 (95% CI: 1.5-2.3) vs . 1.4 (95% CI: 1.3-1.5) months; P=0.004]. Further independent predictive factors for PFS were gender, age, and hepatic/brain metastases (P vs . 62%), as well as a comparable DCR (29% vs . 28%), which was associated with prolonged survival (4.5 vs . 3.2 months for refractory cases, P=0.034). - Conclusions: Paclitaxel has clinically relevant activity in heavily pretreated SCLC. While patients with good PS and no cerebral/hepatic metastases derive the greatest benefit, ECOG PS 2 per se should not be used as a criterion to exclude patients. |
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| Item Description: | Gesehen am 17.04.2020 |
| Physical Description: | Online Resource |
| ISSN: | 2077-6624 |
| DOI: | 10.21037/jtd.2019.12.74 |