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01-09-2015 | Original Article

Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease

Authors: Yasunori Enomoto, Naoki Inui, Shiro Imokawa, Masato Karayama, Hirotsugu Hasegawa, Yuichi Ozawa, Takashi Matsui, Koshi Yokomura, Takafumi Suda

Published in: Cancer Chemotherapy and Pharmacology | Issue 3/2015

Abstract

Purpose

To investigate the safety of intravenous topotecan monotherapy for relapsed small cell lung cancer (SCLC) patients with pre-existing interstitial lung disease (ILD).

Methods

A total of 77 patients who received topotecan for the treatment of relapsed SCLC between April 2007 and April 2014 were reviewed. Patients with pre-existing ILD were identified using the pretreatment chest computed tomography. The safety of intravenous topotecan for SCLC patients with ILD was retrospectively examined, particularly focusing on topotecan-induced acute exacerbation of ILD (AE-ILD).

Results

Twenty-three patients were identified as having pre-existing ILD [median age 74 (range 55–85) years; 21 men]. At the first topotecan administration, two-thirds (65.2 %) had an Eastern Cooperative Oncology Group performance status 0 or 1. Topotecan was administered intravenously as second-line (n = 11) or later chemotherapy (n = 12). The median number of treatment cycles was two (range 1–7). The most common adverse events with grade 3 or 4 were neutropenia in 13 patients (56.5 %) and thrombocytopenia in 10 patients (43.5 %). Febrile neutropenia was observed in six patients (26.1 %) and resulted in one death. AE-ILD occurred in five patients (21.7 %; 95 % confidence interval 4.9–38.5 %) 5–18 days after the last administration of topotecan and was fatal in three cases.

Conclusions

Intravenous topotecan monotherapy can be unsafe for relapsed SCLC patients with pre-existing ILD. Clinicians should be cautious regarding topotecan-induced AE-ILD as a lethal complication.

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Title: Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease
Authors: Yasunori Enomoto
Naoki Inui
Shiro Imokawa
Masato Karayama
Hirotsugu Hasegawa
Yuichi Ozawa
Takashi Matsui
Koshi Yokomura
Takafumi Suda
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: Cancer Chemotherapy and Pharmacology / Issue 3/2015
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-015-2816-6

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