Topotecan in the treatment of relapsed small cell lung cancer

Figures & data

Table 1 Phase II/III studies of topotecan as single agent in relapsed SCLC

Schedule	Author	Year	Phase	No patients	RR %	RD (months)	TTP (months)	MST (months)
iv 1.5 mg/m^2 days 1–5	Ardizzoni	1997	II	45 s	37	4.75	4.06	6.9
				47 r	6	7.04	1.9	4.7
iv 1.5 mg/m^2 days 1–5	Perez-Soler	1998	II	32 r	11	–	–	4.6
iv 1.5 mg/m^2 days 1–5	Park	2008	II	17 r	11.8	–	1.7	3.4
iv adjusted to toxicity	Huber	2006	II	111 s	17.1	3.12	1.84	5.37
				59 r	8.6
iv 1.5 mg/m^2 oral	Von Pawel	2001	R II	54 s	15	4.15	3.42	5.74
2.3 mg/m^2 days 1–5				52 s	23	3.19	3.00	7.34
Weekly 4 mg/m^2	Shah	2007	II	22 s	0	–	1.37	5.00
iv 1.5 mg/m^2 days 1–5	Von Pawel	1999	III	211 ± s	24.3	3.3	3.05	5.74
oral 2.3 mg/m^2	O’Brien	2006	III	71a	7	–	–	5.94
oral 2.3 mg/m^2	Eckardt	2007	III	153	18.3	4.2	2.73	7.57
iv 1.5 mg/m^2 days 1–5				151	21.9	5.83	3.35	8.03

a unsuitable for iv chemotherapy.

Abbreviations: iv, intravenous; s, sensitive; r, refractory; R, randomized; RR, response rate; RD, response duration; TTP, time to progression; MST, median survival time. prognosis population and using the most convenient schedule (oral), and in sensitive patients when rechallenging the firstline treatment is not indicated.

Table 2 grade 3–4 hematological toxicities in phase II/III topotecan as single agent in relapsed SCLC (% patients)

Schedule	Author	Year	Phase	No patients	Grade 3–4 neutropenia	Grade 3–4 thrombocytopenia	Grade 3–4 anemia
iv 1.5 mg/m^2 days 1–5	Ardizzonia	1997	II	45 s 47 r	74.9%	29.5%	11.8%
iv 1.5 mg/m^2 days 1–5	Perez-Solera	1998	II	32 r	70%	31%	–
iv 1.5 mg/m^2 days 1–5	Park	2008	II	17 r	65%
iv adjusted to toxicity	Huber	2006	II	111 s 59 r	27.6%	13.5%	1.7%
iv 1.5 mg/m^2 oral	Von Pawel	2001	R II	54 s	93.2%	49%	30.4%
2.3 mg/m^2 days 1–5				52 s	56.9%	52%	31.4%
Weekly 4 mg/m^2	Shah	2007	II	22 s
iv 1.5 mg/m^2 days 1–5	Von Pawel	1999	III	211 ± s	88.5%	57.6%	42.3%
oral 2.3 mg/m^2	O’Brien	2006	III	71	61%	38%	25%
oral 2.3 mg/m^2	Eckardt	2007	III	153	73.2 %	48.7%	22.6%
iv 1.5 mg/m^2 days 1–5				51	87.8%	43.3%	30.7%

a toxicity provided as a percentage of courses.