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Published on: February 12, 2017
Amrubicin monotherapy for patients with previously treated advanced large-cell neuroendocrine carcinoma of the lung
Hiroshi Yoshida1, Ikuo Sekine, Koji Tsuta
1Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.
Objective:
No standard chemotherapy has been established yet for large-cell neuroendocrine carcinoma of the lung. Amrubicin is active for both small cell and non-small cell lung cancers, but its activity for large-cell neuroendocrine carcinoma is still unknown.
Methods:
From January 2002 to December 2009, 18 patients with previously treated advanced large-cell neuroendocrine carcinoma received amrubicin monotherapy. The efficacy and toxicity of the treatment were analyzed retrospectively.
Results:
The patients comprised 17 males and one female with a median age of 62 years (range, 51-77). Fourteen and four patients had a performance status of 0-1 and 2, respectively. Thirteen (72%) patients had received one prior chemotherapy, while the others had received two or more chemotherapies. All the patients had received platinum-based chemotherapy before the amrubicin treatment. A total of 63 cycles of amrubicin chemotherapy was administered in the 18 patients, with a median number of cycles per patient of 2.5 (range, 1-10). The median dose of amrubicin in the 63 cycles was 40 (range, 30-45) mg/m(2)/day for 3 days. Grades 3-4 neutropenia, thrombocytopenia and anemia were seen in 89, 17 and 22% of the patients, respectively. Grade 3 febrile neutropenia occurred in 33% of the patients. Non-hematological toxicity was generally mild and manageable. There were five cases of partial response, six of stable disease and six of progressive disease among the 18 patients, yielding an objective response rate of 27.7%. The median progression-free and overall survivals of the patients were 3.1 and 5.1 months, respectively.
Conclusion:
Amrubicin was potentially active against previously treated large-cell neuroendocrine carcinoma.
Insights
Amrubicin shows potential activity in treating advanced large-cell neuroendocrine carcinoma of the lung. This retrospective study found a 27.7% objective response rate in previously treated patients.
Area of Science:
- Oncology
- Medical Oncology
- Pulmonology
Background:
- Large-cell neuroendocrine carcinoma (LCNC) of the lung lacks established standard chemotherapy.
- Amrubicin demonstrates activity in small cell and non-small cell lung cancers, but its efficacy in LCNC is unproven.
Purpose of the Study:
- To evaluate the efficacy and toxicity of amrubicin monotherapy in patients with previously treated advanced LCNC.
Main Methods:
- Retrospective analysis of 18 patients with advanced LCNC who received amrubicin monotherapy between 2002 and 2009.
- Patients had received prior platinum-based chemotherapy.
Main Results:
- The objective response rate was 27.7% (5 partial responses, 6 stable disease).
- Grade 3-4 neutropenia occurred in 89% of patients; 33% experienced febrile neutropenia.
- Median progression-free survival was 3.1 months, and median overall survival was 5.1 months.
Conclusions:
- Amrubicin monotherapy demonstrated potential activity in previously treated advanced LCNC.
- Toxicity was manageable, with neutropenia and febrile neutropenia being the main concerns.
