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Hisao Imai
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P1.15 - SCLC/Neuroendocrine Tumors (ID 701)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.15-002 - A Retrospective Study of Amrubicin Monotherapy for the Treatment of Relapsed Small Cell Lung Cancer in Elderly Patients (ID 7330)
09:30 - 09:30 | Author(s): Hisao Imai
- Abstract
Background:
Amrubicin is one of the most active chemotherapeutic agents for small-cell lung cancer (SCLC). Previous studies reported its effectiveness and severe hematological toxicity. However, the efficacy of amrubicin monotherapy in elderly patients with SCLC has not been described. The objective of this study was to investigate the feasibility of amrubicin monotherapy in elderly patients, and its efficacy for relapsed SCLC.
Method:
A retrospective cohort study design was used. We retrospectively evaluated the clinical effects and adverse events of amrubicin treatment in elderly (≥70 years) SCLC patients with relapsed SCLC at one of four Japanese institutions (Gunma Prefectural Cancer Center, Tochigi Prefectural Cancer Center, Ibaragi Central Hospital, and Fukushima Medical University).
Result:
Between November 2003 and September 2015, 86 patients (aged ≥70 years) received amrubicin monotherapy for relapsed SCLC at four institutions There were 42 cases of sensitive relapse (S) and 44 of refractory relapse (R). S cases with median age of 75 years (range, 70–85 years) and R cases with median age of 74 years (range, 70–84 years) were included in our analysis. The median number of treatment cycles was 3 (range 1–9), and the response rate was 33.7% (40.5% in the S and 27.2% in the R cases). Median progression-free survival time was 4.0 months in the S and 2.7 months in the R patients (p = 0.013). Median survival time from the start of amrubicin therapy was 7.6 months in the S and 5.5 months in the R cases (p = 0.26). The frequencies of grade ≥3 hematological toxicities were as follows: leukopenia, 60.4%; neutropenia, 74.4%; anemia, 11.6%; thrombocytopenia, 16.2%; and febrile neutropenia, 17.4%. Treatment-related death was observed in 1 patient.
Conclusion:
Although hematological toxicities, particularly neutropenia, were severe, amrubicin showed excellent anti-tumor activity, not only in the S, but also in the R cases, as shown in previous studies. Amrubicin could be a preferable standard treatment in elderly patients with relapsed SCLC. These results warrant further evaluation of amrubicin in elderly patients with relapsed SCLC by a prospective trial.
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P2.15 - SCLC/Neuroendocrine Tumors (ID 716)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: SCLC/Neuroendocrine Tumors
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.15-005 - Post-Progression Survival Is Strongly Linked to Overall Survival in Refractory Small-Cell Lung Cancer Patients Who Received Amrubicin (ID 8845)
09:30 - 09:30 | Presenting Author(s): Hisao Imai
- Abstract
Background:
The benefits of second-line chemotherapy on the overall survival (OS) of small-cell lung cancer (SCLC) patients might be confounded by subsequent therapies. In this study, we aimed to determine the influence of progression-free survival (PFS) and of post-progression survival (PPS) on OS after second-line chemotherapy in patients with refractory SCLC treated with amrubicin monotherapy.
Method:
We analyzed the data of 35 patients with refractory SCLC who were treated with amrubicin monotherapy as second-line chemotherapy between July 2005 and December 2015. The correlations of PFS and PPS with OS were statistically analyzed at the individual level using Spearman rank correlation and linear regression analyses.
Result:
The correlation between PPS and OS was strong (r = 0.88, p < 0.05, R[2 ]= 0.87), while that between PFS and OS was weak (r = 0.60, p < 0.05, R[2] = 0.15). The number of regimens administered after disease progression post-second-line chemotherapy was significantly associated with PPS (p = 0.003).
Conclusion:
OS is more strongly linked to PPS than to PFS in refractory SCLC patients who undergo amrubicin monotherapy as a second-line treatment. Moreover, receiving additional regimens after second-line treatment is a significant independent prognostic factor for PPS. Taken together, our results indicate that additional treatments administered after second-line chemotherapy favorably affect the OS of refractory SCLC patients treated with amrubicin monotherapy.