Journal List > J Lung Cancer > v.9(1) > 1050716

Lee, Lee, Park, Jung, Kim, and Kim: Belotecan and Cisplatin Combination Chemotherapy for Previously Untreated Extensive-Disease Small Cell Lung Cancer

Abstract

Purpose

Belotecan (Camtobell; Chong Keun Dang Co., Seoul, Korea) is a new camptothecin analog that inhibits topoisomerase I. We evaluated the efficacy and toxicity of belotecan combined with cisplatin in patients with previously untreated extensive-disease small cell lung cancer (ED-SCLC) and who were without evidence of brain metastases.

Materials and Methods

Twenty patients with previously untreated ED-SCLC were treated with belotecan (0.5 mg/m2/day) on days 1∼4 and with cisplatin (60 mg/m2/day) on day 1 of a 3-week cycle.

Results

Of the 19 assessable patients, 16 had an objective tumor response, including two complete responses, for an overall response rate of 84.2%. Toxicity was evaluated in all 20 patients who received a total of 106 cycles (median cycles/patient, 5.5; range, 1∼9). The major grade 3/4 hematologic toxicities were neutropenia (67.9% of cycles), anemia (19.8% of cycles) and thrombocytopenia (33.9% of cycles). No grade 3/4 non-hematologic toxicities were observed. No treatment-related deaths occurred. The median progression-free and overall survivals were 7.06 months (95% confidence interval [CI], 3.98∼10.14 months) and 9.96 months (95% CI, 6.12∼13.80 months), respectively.

Conclusion

Combination chemotherapy with belotecan plus cisplatin is an effective treatment for ED-SCLC with acceptable hematologic and non-hematologic toxicities.

References

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Figures and Tables

Fig. 1.
Kaplan-Meier estimates of survival outcomes are illustrated. Tick marks indicate censored data.
jlc-9-15f1.tif
Table 1.
Patient Characteristics
Characteristic No. of patients (%)
Total number enrolled 20
Eligible for response evaluation 19
Age, median (range), yr 65.5 (49∼76)
Gender  
 Male 15 (75.0)
 Female 5 (25.0)
Performance status  
 1 13 (65.0)
 2 6 (30.0)
 3 1 (5.0)
Metastatic site  
 Bone 15 (53.5)
 Liver 4 (14.3)
 Lung 3 (10.7)
 Adrenal gland 3 (10.7)
 Other 3 (10.7)
Table 2.
Tumor Responses
Response n (%)
 Complete response 2 (10.5)
 Partial response 14 (73.7)
 Stable disease 2 (10.5)
 Progressive disease 1 (5.3)
 Objective response 16/19 (84.2)
 Total 19
Table 3.
Toxicity Profile by Cycles
Adverse event No. of toxicities/Total cycles (%) (total cycles=106)
Grade 1 Grade 2 Grade 3 Grade 4
Hematologic toxicity, n (%)        
 Leukopenia 39 (36.8) 17 (16.0) 28 (26.4) 22 (20.7)
 Neutropenia 28 (26.4) 6 (5.7) 17 (16.0) 55 (51.9)
 Anemia 40 (37.7) 45 (42.5) 16 (15.1) 5 (4.7)
 Thrombocytopenia 59 (55.7) 11 (10.4) 21 (19.8) 15 (14.1)
Non-hematologic toxicity, n (%)        
 Alopecia 69 (65.1) 37 (34.9) 0 (0) 0 (0)
 Anorexia 92 (86.7) 14 (13.2) 0 (0) 0 (0)
 Nausea/vomiting 97 (91.5) 9 (8.5) 0 (0) 0 (0)
 Constipation 106 (100) 0 (0) 0 (0) 0 (0)
 Diarrhea 104 (98.1) 2 (1.9) 0 (0) 0 (0)
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