Therapy of small cell lung cancer with emphasis on oral topotecan

Pirker, Robert; Berzinec, Peter; Brincat, Stephen; Kasan, Peter; Ostoros, Gyula; Pesek, Milos; Plāte, Signe; Purkalne, Gunta; Rooneem, Regina; Skřičková, Jana; Stanculeanu, Dana; Timcheva, Constanta; Tzekova, Valentina; Zakotnik, Branko; Zielinski, Christoph C.; Zwitter, Matjaz

doi:10.1016/j.lungcan.2010.05.020

« Previous Next »Lung Cancer
Volume 70, Issue 1 , Pages 7-13, October 2010

Therapy of small cell lung cancer with emphasis on oral topotecan

Robert Pirker
- Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
- Corresponding author. Tel.: +43 1 40400 4422; fax: +43 1 40400 4461.
Peter Berzinec
- Department of Oncology, Specialised Hospital of St. Zoerardus Zobor, Nitra, Slovakia
- Co-authors according to alphabetical order.
Stephen Brincat
- Sir Paul Boffa Hospital, Floriana, Malta
Peter Kasan
- Department of Oncology, University Hospital Bratislava, Slovakia
Gyula Ostoros
- National Korányi Institute for Tuberculosis and Pulmonology, Budapest, Hungary
Milos Pesek
- Pneumology, Medical Faculty, Charles University, Plzen, Czech Republic
Signe Plāte
- Riga Easten University Hospital, Riga, Latvia
Gunta Purkalne
- Radiation and Chemotherapy Center, Paul Stradins Clinical University Hospital Riga, Latvia
Regina Rooneem
- North Estonia Regional Hospital, Cancer Centre, Department of Chemotherapy, Tallinn, Estonia
Jana Skřičková
- Department of Respiratory Diseases and TB, University Hospital, Brno, Czech Republic
Dana Stanculeanu
- Institute of Oncology, Bucharest, Romania
Constanta Timcheva
- Specialized Hospital for Active Treatment in Oncology, Sofia, Bulgaria
Valentina Tzekova
- Clinic of Chemotherapy, University Hospital Queen Joanna, ISUL, Sofia, Bulgaria
Branko Zakotnik
- Division of Medical Oncology, Institute of Oncology Ljubljana, Slovenia
Christoph C. Zielinski
- Department of Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
Matjaz Zwitter
- Department of Radiation Oncology, Institute of Oncology Ljubljana, Slovenia

Received 9 March 2010; received in revised form 18 May 2010; accepted 23 May 2010. published online 24 June 2010.

Abstract

Systemic chemotherapy plays the major role in the management of patients with small cell lung cancer. Cisplatin plus etoposide is the most widely used regimen and is considered as standard in patients with limited disease. Cisplatin plus irinotecan improved survival compared to cisplatin plus etoposide in a Japanese trial but failed to do so in two trials in Caucasians. Cisplatin plus topotecan had similar efficacy compared to cisplatin plus etoposide in patients with extensive disease. In the second-line setting, topotecan showed similar efficacy but better tolerability compared to cyclophosphamide, doxorubin plus vincristine. Oral topotecan was as efficacious as its intravenous formulation and was shown to improve survival compared to best supportive care alone in patients previously treated with chemotherapy. Thus topotecan is considered as the standard second-line chemotherapy in patients with small cell lung cancer.

Keywords: Chemotherapy, New drugs, Thoracic radiotherapy, Brain irradiation, Second-line therapy, Topotecan