Management of Recurrent Small Cell Lung Cancer

Author:
Bryan J. Schneider From the University of Michigan, Ann Arbor, Michigan.

Search for other papers by Bryan J. Schneider in
Current site
Google Scholar
PubMed Close
 MD
Volume/Issue:
Volume 6: Issue 3
Online Publication Date:
Mar 2008
DOI:
https://doi.org/10.6004/jnccn.2008.0027
Full access

Small cell lung cancer remains one of the more frustrating malignancies for oncologists to treat. Although responses to initial platinum-based chemotherapy are high, most are not durable, and many patients are candidates for further palliative chemotherapy. Therapeutic options include reinduction or single-agent chemotherapy, depending on the duration of response to front-line treatment. Topotecan is the only approved agent for patients with relapsed disease. Several phase II studies have shown a modest benefit with other agents used today, although combination chemotherapy should be avoided because of increased toxicity. Palliative care should always be the focus, especially in patients with recurrent or chemorefractory small cell lung cancer and a poor performance status.

Correspondence: Bryan J. Schneider, MD, University of Michigan, C340 MIB 5848, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5848. E-mail: bryansch@med.umich.edu
  • Collapse
  • Expand
Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
  • 1.

    O'Brien ME, Ciuleanu TE, Tsekov H et al.. Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small-cell lung cancer. J Clin Oncol 2006;24:5441–5447.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Postmus PE, Berendsen HH, van Zandwijk et al.. Retreatment with the induction regimen in small cell lung cancer relapsing after and initial response to short term chemotherapy. Eur J Cancer Clin Oncol 1987;23:1409–1411.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Giaccone G, Ferrati P, Donadio M et al.. Reinduction chemotherapy in small cell lung cancer. Eur J Cancer Clin Oncol 1987;23:1697–1699.

  • 4.

    Vincent M, Evans B, Smith I. First-line chemotherapy rechallenge after relapse in small cell lung cancer. Cancer Chemother Pharmacol 1988;21:45–48.

  • 5.

    Perez-Soler R, Glisson BS, Lee JS et al.. Treatment of patients with small-cell lung cancer refractory to etoposide and cisplatin with the topoisomerase I poison topotecan. J Clin Oncol 1996;14:2785–2790.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Ardizzoni A, Hansen H, Dombernowsky P et al.. Topotecan, a new active drug in the second-line treatment of small-cell lung cancer: a phase II study in patients with refractory and sensitive disease. J Clin Oncol 1997;15:2090–2096.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Von Pawel J, Schiller JH, Shepherd FA et al.. Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol 1999;17:658–667.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Garst J, Buller R, Lane S et al.. Topotecan in the treatment of elderly patients with relapsed small-cell lung cancer. Clin Lung Cancer 2005;7:190–196.

  • 9.

    Treat J, Huang CH, Lane SR et al.. Topotecan in the treatment of relapsed small cell lung cancer patients with poor performance status. Oncologist 2004;9:173–181.

  • 10.

    Shipley DL, Hainsworth JD, Spigel DR et al.. Topotecan: weekly intravenous (IV) schedule similar to standard 5-day IV schedule as second-line therapy for relapsed small cell lung cancer (SCLC)—a Minnie Pearl Cancer Research Network phase II trial [abstract]. J Clin Oncol 2006;24(Suppl 1):384. Abstract 7083.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Shah C, Ready N, Perry M et al.. A multi-center phase II study of weekly topotecan as second-line therapy for small cell lung cancer. Lung Cancer 2007;57:84–88.

  • 12.

    Von Pawel J, Gatzemeier U, Pujol JL et al.. Phase II comparator study of oral versus intravenous topotecan in patients with chemosensitive small-cell lung cancer. J Clin Oncol 2001;19:1743–1749.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Eckardt JR, von Pawel J, Pujol JL et al.. Phase III study of oral compared to intravenous topotecan as second-line therapy in small-cell lung cancer. J Clin Oncol 2007;25:2086–2092.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Dy GK, Jett JR, Geoffroy FJ et al.. Topotecan and paclitaxel in previously treated patients with relapsed small cell lung cancer: phase II trial of the North Central Cancer Treatment Group. J Thorac Oncol 2006;1:211–217.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ardizzoni A, Manegold C, Debruyne C et al.. European Organization for Research and Treatment of Cancer (EORTC) 08957 phase II study of topotecan in combination with cisplatin as second-line treatment of refractory and sensitive small cell lung cancer. Clin Cancer Res 2003;9:143–150.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Choi H, Choi B, Shin S et al.. Topotecan and etoposide as salvage chemotherapy in patients with irinotecan- and platinum-failed small-cell lung cancer: a phase II study [abstract]. J Clin Oncol 2007;25(Suppl 1):698. Abstract 18177.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Belvedere O, Sacco C, Ardizzoni A et al.. Second line chemotherapy with topotecan and gemcitabine in small cell lung cancer (SCLC) patients: an Alpe-Adria Thoracic Oncology Multidisciplinary group phase II study (ATOM 012) [abstract]. J Clin Oncol 2006;24(Suppl 1):668. Abstract 17014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Masuda N, Fukuoka M, Kusunoki Y et al.. CPT-11: a new derivative of camptothecin for the treatment of refractory or relapsed small-cell lung cancer. J Clin Oncol 1992;10:1225–1229.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Fujita A, Takabatake H, Tagaki S et al.. [Pilot study of irinotecan in refractory small cell lung cancer]. Gan to Kgaku Ryoho 1995;22:889–893 [in Japanese].

  • 20.

    Nakanishi Y, Takayama K, Takano K et al.. Second-line chemotherapy with weekly cisplatin and irinotecan in patients with refractory lung cancer. Am J Clin Oncol 1999;22:399–402.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Ando M, Kobayashi K, Yoshimura A et al.. Weekly administration of irinotecan (CPT-11) plus cisplatin for refractory or relapsed small cell lung cancer. Lung Cancer 2004;44:121–127.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Naka N, Kawahara M, Okishio K et al.. Phase II study of weekly irinotecan and carboplatin for refractory or relapsed small-cell lung cancer. Lung Cancer 2002;37:319–323.

  • 23.

    Hirose T, Horichi N, Ohmori T et al.. Phase II study of irinotecan and carboplatin in patients with the refractory or relapsed small cell lung cancer. Lung Cancer 2003;40:333–338.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Masuda N, Matsui K, Negoro S et al.. Combination of irinotecan and etoposide for treatment of refractory or relapsed small-cell lung cancer. J Clin Oncol 1998;16:3329–3334.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Goto K, Sekine I, Nishiwaki Y et al.. Multi-institutional phase II trial of irinotecan, cisplatin, and etoposide for sensitive relapsed small-cell lung cancer. Br J Cancer 2004;91:659–665.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Fujita A, Takabatake H, Tagaki S et al.. Combination of cisplatin, ifosfamide, and irinotecan with rhG-CSF support for the treatment of refractory or relapsed small-cell lung cancer. Oncology 2000;59:105–109.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Einhorn LH, Pennington K, McClean J. Phase II trial of daily oral VP-16 in refractory small cell lung cancer: a Hoosier Oncology Group study. Semin Oncol 1990;17:32–35.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Johnson DH, Greco FA, Strupp J et al.. Prolonged administration of oral etoposide in patients with relapsed or refractory small-cell lung cancer: a phase II trial. J Clin Oncol 1990;8:1613–1617.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Smit EF, Fokkema E, Biesma B et al.. A phase II study of paclitaxel in heavily pretreated patients with small-cell lung cancer. Br J Cancer 1998;77:347–351.

  • 30.

    Sonpavde G, Ansari R, Walker P et al.. Phase II study of doxorubicin and paclitaxel as second-line chemotherapy of small-cell lung cancer. A Hoosier Oncology Group trial. Am J Clin Oncol 2000;23:68–70.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Agelaki S, Veslemes M, Syrigos K et al.. A multicenter phase II study of the combination of gemcitabine and docetaxel in previously treated patients with small cell lung cancer. Lung Cancer 2004;43:329–333.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Groen H, Fokkema E, Biesma B et al.. Paclitaxel and carboplatin in the treatment of small-cell lung cancer patients resistant to cyclophosphamide, doxorubicin, and etoposide: a non-cross-resistant schedule. J Clin Oncol 1999;17:927–932.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Owonikoko TK, Ramalingam S, Forster J et al.. Phase II study of irinotecan and paclitaxel for patients with recurrent small cell lung cancer (SCLC) [abstract]. J Clin Oncol 2007;25(Suppl 1):684. Abstract 18011.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Smyth JF, Smith IE, Sessa C et al.. Activity of docetaxel (Taxotere) in small cell lung cancer. Eur J Cancer 1994;30:1058–1060.

  • 35.

    Yokoyama A, Kurita Y, Watanabe K et al.. [Early phase II clinical study of RP56976 (docetaxel) in patients with primary pulmonary cancer. Docetaxel cooperative study group for lung cancer.] Gan to Kagaku Ryoho 1994;21:2609–2616 [in Japanese].

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Masters G, Declerck L, Blanke C et al.. Phase II trial of gemcitabine in refractory or relapsed small-cell lung cancer: eastern cooperative oncology group trial 1597. J Clin Oncol 2003;21:1550–1555.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Hoang T, Kim K, Jaslowski A et al.. Phase II study of second-line gemcitabine in sensitive or refractory small cell lung cancer. Lung Cancer 2003;42:97–102.

  • 38.

    Schuette W, Nagel S, Juergens S et al.. Phase II trial of gemcitabine/irinotecan in refractory or relapsed small-cell lung cancer. Clin Lung Cancer 2005;7:133–137.

  • 39.

    Rocha-Lima CM, Herndon E II, Lee ME et al.. Phase II trial of irinotecan/gemcitabine as second-line therapy for relapsed and refractory small-cell lung cancer: Cancer and Leukemia Group B study 39902. Ann Oncol 2007;18:331–337.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Rapti A, Agelidou A, Stergiou I et al.. Combination of vinorelbine plus gemcitabine in previously treated patients with small cell lung cancer: a multicentre phase II study. Lung Cancer 2005;49:241–244.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Hainsworth JD, Burris HA III, Erland JB et al.. Combination chemotherapy with gemcitabine and vinorelbine in the treatment of patients with relapsed or refractory small cell lung cancer: a phase II trial of the Minnie Pearl Cancer Research Network. Cancer Invest 2003;21:193–199.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Furuse K, Kubota K, Kawahara M et al.. Phase II study of vinorelbine in heavily previously treated small cell lung cancer. Oncology 1996;53:169–172.

  • 43.

    Jassem J, Karnicka-Mlodkowska H, van Pottelsberghe C et al.. Phase II study of vinorelbine (Navelbine) in previously treated small cell lung cancer patients. EORTC Lung Cancer Cooperative Group. Eur J Cancer 1993;29A:1720–1722.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Cantwell BM, Bozzino JM, Corris P et al.. The multidrug resistant phenotype in clinical practice; evaluation of cross resistance to ifosfamide and mesna after VP16-213, doxorubicin, and vincristine (VPAV) for small cell lung cancer. Eur J Cancer Clin Oncol 1988;24:123–129.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Hanna NH, Ansari R, Bhatia S et al.. Pemetrexed in patients (pts) with relapsed small cell lung cancer (SCLC): a phase II study from the Hoosier Oncology Group [abstract]. J Clin Oncol 2006;24(18S):Abstract 7063.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Raju RN, Neubauer MA, Smith DA et al.. Pemetrexed (P) in relapsed small cell lung cancer (SCLC): preliminary results of a phase II trial [abstract]. J Clin Oncol 2007;25(Suppl 1):438. Abstract 7716.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Kosmas C, Tsavaris NB, Malamos NA et al.. Phase II study of paclitaxel, ifosfamide, and cisplatin as second-line treatment in relapsed small-cell lung cancer. J Clin Oncol 2001;19:119–126.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Faylona EA, Loehrer PJ, Ansari R et al.. Phase II study of daily oral etoposide plus ifosfamide plus cisplatin for previously treated recurrent small-cell lung cancer: a Hoosier Oncology Group trial. J Clin Oncol 1995;13:1209–1214.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 49.

    Shepherd FA, Evans WK, MacCormick R et al.. Cyclophosphamide, doxorubicin and vincristine in etoposide- and cisplatin-resistant small cell lung cancer. Cancer Treat Rep 1987;71:941–955.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 50.

    Roth BJ, Johnson DH, Einhorn LH et al.. Randomized study of cyclophosphamide, doxorubicin, and vincristine versus etoposide and cisplatin versus alternation of these two regimens in extensive small-lung cancer: a phase III trial of the southeastern cancer study group. J Clin Oncol 1992;10:282–291.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 51.

    Kudoh S, Yoshimura N, Kimura T et al.. A phase II trial of amrubicin (AMR) for recurrent or refractory small cell lung cancer (SCLC) [abstract]. J Clin Oncol 2006;24(Suppl 1):671. Abstract 17053.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 52.

    Onoda S, Masuda N, Seto T et al.. Phase II trial of amrubicin for the treatment of refractory or relapsed small-cell lung cancer: Thoracic Oncology Research Group study 0301. J Clin Oncol 2007;24:5448–5453.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 53.

    Jotte RM, Reynolds CH, Conkling P et al.. A randomized phase 2 trial of amrubicin compared to topotecan as second-line treatments in extensive disease small cell lung cancer (SCLC) sensitive to platinum-based first-line chemotherapy [abstract]. J Clin Oncol 2007;25(18S):Abstract 18064.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 54.

    Bentzion D, Lipatov O, Polyakov I et al.. A phase II study of picoplatin (pico) as second-line therapy for patients (pts) with small cell lung cancer (SCLC) who have resistant or refractory disease or have relapsed within 180 days of completing first-ling, platinum (plat)-containing chemotherapy [abstract]. J Clin Oncol 2007;25(Suppl 1):439. Abstract 7722.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 55.

    Mekhail T, Gettinger S, Blumenschein G et al.. A phase II trial of VNP40101M in patients with relapsed or refractory small cell lung cancer (SCLC) with or without brain metastases [abstract]. J Clin Oncol 2007;25(Suppl 1):439. Abstract 7724.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 56.

    Stefanou D, Batistatou A, Arkoumani E et al.. Expression of vascular endothelial growth factor (VEGF) and association with microvessel density in small cell and non-small-cell lung carcinoma. Histol Histopathol 2004;19:37–42.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 57.

    Kim Y, Goto K, Yoh K et al.. Prognostic factors for response and survival of second-line chemotherapy in patients with relapsed small cell lung cancer (SCLC) [abstract]. J Clin Oncol 2007;25(Suppl 1):685. Abstract 18023.

    • PubMed
    • Search Google Scholar
    • Export Citation
Copyright:
Copyright © 2008 by the National Comprehensive Cancer Network
Page Numbers:
9
Article Category:
Research Article
Received:
24 Sep 2007
Accepted:
07 Nov 2007
Print Publication Date:
01 Mar 2008
Online Publication Date:
Mar 2008
Keywords:
Small cell lung cancer; relapse; second-line chemotherapy; review; therapeutics

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 919 358 10
PDF Downloads 517 99 9
EPUB Downloads 0 0 0