Efficacy of second-line chemotherapy in poor-risk patients with refractory-relapsed small-cell lung cancer

The treatment efficacy of second-line chemotherapy in poor-risk patients with refractory-relapsed small-cell lung cancer is unclear.

We defined refractory relapse as treatment-free interval <90 days and poor-risk as Eastern Cooperative Oncology Group Performance Status ≥2. We retrospectively examined the medical record data of patients who were treated at our hospital between September 2002 and December 2014.

Twenty-three poor-risk patients with refractory-relapsed small-cell lung cancer were treated in our hospital. The characteristics of patients at the time of first-line treatment were as follows: median age (range) 71 (57-83) years; male 74%; extensive disease 96%; proportion of patients with PS 0 or 1 and those with 2-4 was 43 and 57%, respectively; median treatment-free interval 26 days. Amrubicin was the most commonly used drug and was administered in 15 patients (65%). The overall response rate of all patients was 22%. Median progression-free survival and overall survival was 2.2 and 3.7 months, respectively. Among patients treated with amrubicin, overall response rate was 13%, median progression-free survival was 2.2 months, and median overall survival was 3.9 months. The most common grade 3 or worse adverse events were hematologic toxicities, including leukopenia (66%), neutropenia (69%), thrombocytopenia (9%) and anemia (22%). Febrile neutropenia was observed in two patients (9%).

Second-line chemotherapy might have poor efficacy to poor-risk patients with refractory-relapsed small-cell lung cancer.