Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease.

Abstract:

PURPOSE:To investigate the safety of intravenous topotecan monotherapy for relapsed small cell lung cancer (SCLC) patients with pre-existing interstitial lung disease (ILD). METHODS:A total of 77 patients who received topotecan for the treatment of relapsed SCLC between April 2007 and April 2014 were reviewed. Patients with pre-existing ILD were identified using the pretreatment chest computed tomography. The safety of intravenous topotecan for SCLC patients with ILD was retrospectively examined, particularly focusing on topotecan-induced acute exacerbation of ILD (AE-ILD). RESULTS:Twenty-three patients were identified as having pre-existing ILD [median age 74 (range 55-85) years; 21 men]. At the first topotecan administration, two-thirds (65.2%) had an Eastern Cooperative Oncology Group performance status 0 or 1. Topotecan was administered intravenously as second-line (n = 11) or later chemotherapy (n = 12). The median number of treatment cycles was two (range 1-7). The most common adverse events with grade 3 or 4 were neutropenia in 13 patients (56.5%) and thrombocytopenia in 10 patients (43.5%). Febrile neutropenia was observed in six patients (26.1%) and resulted in one death. AE-ILD occurred in five patients (21.7%; 95% confidence interval 4.9-38.5 %) 5-18 days after the last administration of topotecan and was fatal in three cases. CONCLUSIONS:Intravenous topotecan monotherapy can be unsafe for relapsed SCLC patients with pre-existing ILD. Clinicians should be cautious regarding topotecan-induced AE-ILD as a lethal complication.

authors

Enomoto Y,Inui N,Imokawa S,Karayama M,Hasegawa H,Ozawa Y,Matsui T,Yokomura K,Suda T

doi

10.1007/s00280-015-2816-6

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

499-505

issue

3

eissn

0344-5704

issn

1432-0843

journal_volume

76

pub_type

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