J Cancer 2015; 6(11):1148-1154. doi:10.7150/jca.13080
Second-Line Therapy of Small-Cell Lung Cancer: Topotecan Compared to a Combination Treatment with Adriamycin, Cyclophosphamide And Vincristine (ACO) - a Single Center Experience
1. Department Internal Medicine, Medical Oncology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
2. Lung Tumor Center, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
Hagmann R, Hess V, Zippelius A, Rothschild SI. Second-Line Therapy of Small-Cell Lung Cancer: Topotecan Compared to a Combination Treatment with Adriamycin, Cyclophosphamide And Vincristine (ACO) - a Single Center Experience. J Cancer 2015; 6(11):1148-1154. doi:10.7150/jca.13080. Available from http://www.jcancer.org/v06p1148.htm
Background: Randomized trials established topotecan and the combination of adriamycin, cyclophosphamide and vincristine (ACO) as second-line therapy options for small-cell lung cancer. We retrospectively evaluated the outcome of SCLC patients undergoing second-line chemotherapy.
Patients and Methods: 92 consecutive patients with a diagnosis of SCLC between 2000 and 2010 were analyzed.
Results: 86 patients (93.5%) were evaluable for outcome analysis. All patients diagnosed with limited disease (LD) SCLC received platinum-based chemotherapy as first-line treatment. 69 patients (98.6%) diagnosed with extensive disease (ED) SCLC received first-line palliative chemotherapy. In the total cohort, the median overall survival (OS) was 10.3 months (19.2 months and 9.2 months for LD-SCLC and ED-SCLC, respectively). 42 patients received second-line therapy (ACO in 47.6% and topotecan in 31.0% of patients, respectively). Eight patients (19.0%) were re-challenged with platinum/etoposide. Neither the overall response rate (52.9% vs. 22.2%; p=0.128) nor progression-free survival (2.4 vs. 2.4 months; p=0.794) or OS (5.5 vs. 5.0 months; p=0.997) were significantly different between ACO and topotecan. ACO-treated patients showed a trend towards a longer duration of inpatient care.
Conclusion: We showed similar outcomes as reported in clinical trials. Second-line combination chemotherapy with ACO did not show superiority to intravenous topotecan, but was associated with a clinically relevant longer hospitalization time.
Keywords: Small cell lung cancer, second-line therapy, chemotherapy, topotecan, ACO