Topotecan for Relapsed Small-cell Lung Cancer: Systematic Review and Meta-Analysis of 1347 Patients

• Published in: Scientific Reports Vol. 5; no. 1; p. 15437
• Main Authors: Horita, Nobuyuki, Yamamoto, Masaki, Sato, Takashi, Tsukahara, Toshinori, Nagakura, Hideyuki, Tashiro, Ken, Shibata, Yuji, Watanabe, Hiroki, Nagai, Kenjiro, Inoue, Miyo, Nakashima, Kentaro, Ushio, Ryota, Shinkai, Masaharu, Kudo, Makoto, Kaneko, Takeshi
• Format: Journal Article
• Language: English
• Published: London Springer Science and Business Media LLC 21.10.2015; Nature Publishing Group UK; Nature Publishing Group
• Subjects: 692/308/409; Anemia; Antineoplastic Combined Chemotherapy Protocols; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Data processing; Disease-Free Survival; Drug-Related Side Effects and Adverse Reactions; Drug-Related Side Effects and Adverse Reactions - epidemiology; Drug-Related Side Effects and Adverse Reactions - pathology; Humanities and Social Sciences; Humans; Lung cancer; Lung carcinoma; Meta-analysis; multidisciplinary; Neoplasm Recurrence, Local; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Neutropenia; Response rates; Science; Side effects; Small Cell Lung Carcinoma; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - epidemiology; Small Cell Lung Carcinoma - pathology; Thrombocytopenia; Topotecan; Topotecan - adverse effects; Topotecan - therapeutic use
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep15437

Topotecan is the most reliable chemotherapy regimen for relapsed small-cell lung carcinoma (SCLC). The efficacy and adverse effects of topotecan as reported by previous studies varied greatly. The inclusion criterion was a prospective study that was able to provide data for 6-month over-all survival (OS) rate, 1-year OS rate, objective responses, and/or adverse effects of single agent topotecan as a second line chemotherapy for SCLC, written in English language as a full article. Any topotecan regimen were allowed. Binary data were meta-analyzed with the random-model generic inverse variance method. We included 14 articles consisted of 1347 patients. Pooled values were estimated as follows. <Refractory relapse> Six-month OS rate: 37% (95% CI: 28–46%). One-year OS rate: 9% (95% CI: 5–13%). Response rate: 5% (95% CI: 1–8%). <Sensitive relapse> Six-month OS rate: 57% (95% CI: 50–64%). One-year OS rate: 27% (95% CI: 22–32%). Response rate: 17% (95% CI: 11–23%). <Adverse effect> Grade III/IV neutropenia 69% (95% CI: 58–80%). Grade III/IV thrombopenia 41% (95% CI: 34–48%). Grade III/IV anemia 24% (95% CI: 17–30%). Non-hematorogical events were rare. Chemotherapy-related death 2% (95% CI: 1–3%). In conclusion, Topotecan provided a possibly promising outcome for sensitive-relapse SCLC and poor outcome for refractory relapse SCLC. Adverse events were mainly hematological.