Novel Cytotoxic Chemotherapies in Small Cell Lung Carcinoma

Small cell lung cancer (SCLC) is one of the deadliest thoracic neoplasms, in part due to its fast doubling time and early metastatic spread. Historically, cytotoxic chemotherapy consisting of platinum–etoposide or anthracycline-based regimens has demonstrated a high response rate, but early chemoresistance leads to a poor prognosis in advanced SCLC. Only a fraction of patients with limited-disease can be cured by chemo-radiotherapy. Given the disappointing survival rates in advanced SCLC, new cytotoxic agents are eagerly awaited. Unfortunately, few novel chemotherapy drugs have been developed in the latest decades. This review describes the results and potential application in the clinical practice of novel chemotherapy agents for SCLC.

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Advanced lung cancer inflammation index as a predictor of response rate in first-line chemotherapy for metastatic non-small cell lung carcinoma patients

Annals of Oncology ◽

10.1093/annonc/mdx671.048 ◽

2017 ◽

Vol 28 ◽

pp. x141

Author(s):

S. Chompoonuch ◽

P. Pratyarattananon ◽

O. Sukreeyapongse ◽

C. Upachar

Keyword(s):

Lung Cancer ◽

Response Rate ◽

Small Cell Lung Carcinoma ◽

Small Cell ◽

Advanced Lung Cancer ◽

Small Cell Lung ◽

First Line ◽

Cell Lung Carcinoma ◽

Cancer Inflammation ◽

Line Chemotherapy

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Radiotherapy for Medically Inoperable Non-Small Cell Lung Cancer at Clinical Stage I and II

Tumori Journal ◽

10.1177/030089160308900115 ◽

2003 ◽

Vol 89 (1) ◽

pp. 75-79 ◽

Cited By ~ 1

Author(s):

Kazunari Yamada ◽

Toshinori Soejima ◽

Yosuke Ota ◽

Ryohei Sasaki ◽

Eisaku Yoden ◽

...

Keyword(s):

Lymph Nodes ◽

Local Control ◽

Significant Influence ◽

Small Cell Lung Carcinoma ◽

Clinical Stage ◽

Survival Rates ◽

Small Cell ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Cause Specific Survival

We reviewed the records of 36 patients with medically inoperable stage l-ll non-small cell lung carcinoma who were treated with radiotherapy. The median dose to the target was 60 Gy with conventional fractionation. Fifteen patients were treated without elective irradiation fields, while the remaining 21 were treated with extended fields including elective mediastinal regional lymph nodes. The overall survival rates at three and five years were 32.3% and 18.8%, the cause-specific survival rates were 40.9% and 27.3%, and the local control rates were 31.7% and 23.8%, respectively. In multivariate analysis the radiation dose had a marginally significant influence on the cause-specific survival, while tumor size had a significant influence on the local control rate. Only one patient had relapse in the regional mediastinal lymph nodes as the only site of metastasis. We conclude that the dose used in the present study is inadequate and recommend that further efforts be made to improve local control by dose escalation within a small target volume.

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Survival of Patients Treated with High-dose Radiotherapy and Concurrent Chemotherapy for Unresectable Non-small-cell Lung Cancer

Oncology & Hematology Review (US) ◽

10.17925/ohr.2010.06.0.32 ◽

2010 ◽

Vol 06 ◽

pp. 32

Author(s):

Steven E Schild ◽

Helen J Ross ◽

◽

Keyword(s):

Standard Dose ◽

Small Cell Lung Carcinoma ◽

Survival Rates ◽

Therapeutic Index ◽

Concurrent Chemotherapy ◽

Small Cell ◽

Phase Iii ◽

High Dose ◽

Small Cell Lung ◽

Cell Lung Carcinoma

Radiotherapy (RT) has been used to treat cancers for 110 years. Today, megavoltage RT is delivered with very precise linear accelerators. Computed tomography and/or positron-emission tomography are used to define both tumor and normal tissue volumes. Powerful computers analyze these volumes in 3D space and design complex treatment plans. Over time, the ratio of dose administered to tumor compared with dose administered to the normal structures has increased, resulting in a better therapeutic index and improved survival. In the 1970s and 1980s, the five-year survival rate of unresectable non-small-cell lung carcinoma was 5% with standard RT alone. Adding chemotherapy before or after radiation improved the five-year survival to about 15%. More recently, concurrent chemotherapy and RT has achieved five-year survival rates of up to 29%. Pilot trials employing chemotherapy and higher-dose RT have resulted in still better local control and survival. A phase III trial of chemotherapy plus either standard-dose RT (60Gy/30) or high-dose RT (74Gy/37) is ongoing. New technology is providing ways to improve the therapeutic ratio and administer greater RT doses more safely.

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Limited small-cell lung carcinoma: High complete response rate and survival with short intensive chemotherapy and extensive irradiation. Results of a pilot study

Lung Cancer ◽

10.1016/0169-5002(94)90387-5 ◽

1994 ◽

Vol 11 (1-2) ◽

pp. 144-145

Keyword(s):

Pilot Study ◽

Lung Carcinoma ◽

Response Rate ◽

Complete Response Rate ◽

Small Cell Lung Carcinoma ◽

Complete Response ◽

Small Cell ◽

Intensive Chemotherapy ◽

Small Cell Lung ◽

Cell Lung Carcinoma

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A Pilot Study of Mitomycin, Ifosfamide and Cisplatin as Outpatient Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer

Tumori Journal ◽

10.1177/030089169107700612 ◽

1991 ◽

Vol 77 (6) ◽

pp. 511-513 ◽

Cited By ~ 2

Author(s):

Gabriella Lucia Mariani ◽

Maria Cristina Pennucci ◽

Gianfranco Addamo ◽

Marco Venturini ◽

Andrea Ardizzoni ◽

...

Keyword(s):

Response Rate ◽

Chemotherapy Regimen ◽

Small Cell Lung Carcinoma ◽

Small Cell ◽

Outpatient Basis ◽

Advanced Stage ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Lost To Follow Up

Twenty-one patients with advanced stage, non-small-cell lung carcinoma were treated with a chemotherapy regimen including: mitomycin (6 mg/m2), ifosfamide (3 g/m2), cisplatin (80 mg/m2). The regimen was administered on an outpatient basis. Two patients were lost to follow-up. Among the 29 patients evaluable for response we registered a response rate of 36.8 %; 36.8% of patients had stable disease, and 15.7 % progressed during treatment. Median duration was 8.7 months and median survival was 11 months. Toxicity was low and easily manageable on an outpatient basis.

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Clinical Outcomes of Chemotherapeutic Molecules as Single and Multiple Agents in Advanced Non-Small-Cell Lung Carcinoma (NSCLC) Patients

Medicina ◽

10.3390/medicina57111252 ◽

2021 ◽

Vol 57 (11) ◽

pp. 1252

Author(s):

Ting Yoon Kwan ◽

Ezharul Hoque Chowdhury

Keyword(s):

Advanced Nsclc ◽

Response Rate ◽

Small Cell Lung Carcinoma ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

Cell Lung Carcinoma ◽

Programmed Death ◽

First Line Treatment

Background and Objectives: Lung cancer is the second most common cancer in the world. Non-small-cell lung carcinoma (NSCLC) makes up 85% of all lung cancer cases and the majority of patients are diagnosed when the cancer is advanced. Over the years, many anticancer drugs have been designed and introduced into the market to treat patients with advanced NSCLC. This review aims to discuss the comparative therapeutic benefits of conventional chemotherapeutics and other drugs available for treating advanced NSCLC. Materials and Methods: A literature search for first-line treatment of advanced NSCLC was carried out on PubMed and Google Scholar. Objective response rate (ORR) and overall survival were chosen as target endpoints. Results: Monotherapy showed lower treatment endpoints compared to combination therapy. Different combinations of platinum-based doublets demonstrated similar efficacies in treating NSCLC. However, pemetrexed–platinum doublets showed significantly better treatment endpoint in patients with non-squamous NSCLC. Most studies showing the best complete response rate (CRR) utilized epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), while most studies producing the best overall survival included programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors in their treatment regimens. Conclusions: The findings of this review indicate that targeted therapy using specific inhibitors is now the most promising first-line anticancer treatment available in the market. However, chemotherapy is still effective in treating advanced NSCLC and is viable as a first-line treatment.

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Cisplatin, Etoposide, and Paclitaxel in the Treatment of Patients With Extensive Small-Cell Lung Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.8.2309 ◽

1999 ◽

Vol 17 (8) ◽

pp. 2309-2309 ◽

Cited By ~ 38

Author(s):

Bonnie S. Glisson ◽

Jonathan M. Kurie ◽

Roman Perez-Soler ◽

Nikolous J. Fox ◽

William K. Murphy ◽

...

Keyword(s):

Phase Ii ◽

Phase Ii Trial ◽

Small Cell Lung Carcinoma ◽

Objective Response ◽

Survival Rates ◽

Maximum Tolerated Dose ◽

Small Cell ◽

Small Cell Lung ◽

Cell Lung Carcinoma ◽

Neutropenic Sepsis

PURPOSE: The combination of cisplatin, etoposide, and paclitaxel was studied in patients with extensive small-cell lung cancer in a phase I component followed by a phase II trial to determine the maximum-tolerated dose (MTD), characterize toxicity, and estimate response and median survival rates. PATIENTS AND METHODS: Forty-one patients were treated between October 1993 and April 1997. Doses for the initial cohort were cisplatin 75 mg/m2 on day 1, etoposide 80 mg/m2/d on days 1 to 3, and paclitaxel 130 mg/m2 on day 1 over 3 hours. Cycles were repeated every 3 weeks for up to six cycles. The MTD was reached in the first six patients. In these six patients and in the next 35 patients, who were entered onto the phase II trial, response and survival were estimated. RESULTS: At the initial dose level, one of six patients developed febrile neutropenia, and five of six achieved targeted neutropenia (nadir absolute granulocyte count, 100 to 1,000/μL) without any other dose-limiting toxicity, defining this level as the MTD. Grade 4 neutropenia was observed in 88 (47%) of 188 total courses administered at or less than the MTD. Neutropenia was associated with fever in only 17 (9%) of 188 courses, but two patients experienced neutropenic sepsis that was fatal. Nonhematologic toxicity greater than grade 2 was observed in 10 (5%) of 188 total courses, with fatigue, peripheral neuropathy, and nausea/vomiting most common. The overall objective response rate was 90% of 38 assessable patients: six complete responses (16%) and 28 partial responses(74%). Median progression-free and overall survival durations were 31 and 47 weeks, respectively. CONCLUSION: The combination of cisplatin, etoposide, and paclitaxel produced response and survival rates similar to those of other combinations and was well tolerated.

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