Background Etoposide-/platinum-based chemotherapy is the standard first-line treatment for extensive-disease small cell lung cancer (SCLC), but responses are short-lived and subsequent options limited

Background Etoposide-/platinum-based chemotherapy is the standard first-line treatment for extensive-disease small cell lung cancer (SCLC), but responses are short-lived and subsequent options limited. (95% CI: 2.8C3.9) months. Main toxicities were fatigue (25%) and polyneuropathy (17%). Dose reduction of 25% was associated with shorter PFS [1.9 (95% CI: 1.5C2.3) 3.2 months for refractory cases, P=0.034). Conclusions Paclitaxel has clinically relevant activity in heavily pretreated SCLC. While patients with good PS and no cerebral/hepatic metastases derive the greatest benefit, ECOG PS 2 per se should not be used as a criterion to exclude patients. shows the exclusion criteria of the 35 patients that were not analyzed; relevant patient characteristics are summarized in and stratified according to ECOG PS in Adverse events of any grade occurred in 58% of patients, grade 3/4 events were documented in 15% of patients. The most frequent complication after paclitaxel administration was fatigue in 46 patients (25% of cases for all grades; 5% for grades 3 and 4). The most frequent grade 3/4 adverse event was hematotoxicity (9%), predominantly with leukocytopenia grade 3/4 in 7 cases (4%). Polyneuropathy of all grades was newly diagnosed in 32 of 185 patients (17%), 3 patients (1.5%) had a grade 3/4 polyneuropathy. Twenty-two patients (12%) reported polyneuropathy from previous cytostatic therapy lines, in three of which neuropathy increased during paclitaxel treatment. Table 4 Toxicities during paclitaxel therapy ECOG PS 0C1 patients 9% for ECOG PS 0C1 ECOG PS 2 for fatigue grade 3/4, but these were not statistically significant (P=0.31 with a Chi-square test). Efficacy of paclitaxel treatment In total, therapeutic response could be assessed in 132 (71%) of the 185 paclitaxel-treated patients. Thirty-one patients (17%) achieved partial remission (PR) as best response to paclitaxel therapy, irrespectively of the therapy line (34 days for patients achieving disease control or not, P=0.10 with a 32/147 ECOG PS 0C1 cases, P 0.01), while age and timing of paclitaxel therapy were not associated Epirubicin Hydrochloride distributor with clinical deterioration leading to omission of restaging. Metastatic status was only associated with clinical deterioration in case of both hepatic and cerebral metastases in patients with ECOG PS 2 (P=0.011). Nevertheless, the entire individual subset with ECOG PS 2 demonstrated a DCR of 29% (1.9 (1.5C2.3) weeks; P=0.004] (22% men, P=0.021 having a Chi-Square check), which itself was an unfavorable element and likely to obscure a potentially beneficial aftereffect of gender dosage decrease 25% ECOG PS 2, Rabbit Polyclonal to GTPBP2 3.8 (95% CI: 3.0C4.6) 2.5 (1.4C3.5) weeks; P=0.002] (metastases in 1 organ program metastases in 1 organ systems; 5.7 (95% CI 4.5C6.8) 4.4 (3.0C5.9) 3.1 (2.7C3.6) weeks; P=0.038] (hepatic 3.three months (2.2C4.4) (P=0.008) cerebral 3.three months (2.6C4.0) (P=0.047) both 2.1 months (1.1C3.1) (P Epirubicin Hydrochloride distributor 0.001)] (dosage decrease 25%, 3.9 (95% CI: 2.9C4.8) 2.5 (1.6C3.3) weeks, P=0.004] (PD/discordant response no staging, 6.4 (95% CI: 5.4C7.4) 3.8 (3.0C4.6) 1.5 (1.1C1.9) months; P 0.001] (PD/discordant response zero staging, 7 (95% CI: 5.8C8.2) 3.9 (3.1C4.7) 1.7 (1.4C1.9) months; P 0.001] (PD/discordant response zero staging, 4.5 (95% CI: 3.9C5.1) 3.2 (2.3C4.2) 0.9 (0.7C1.2) weeks; P 0.001], however, response to paclitaxel treatment increased Operating-system also with this especially delicate human population (DC PD/discordant significantly, 4.5 3.2 months: P=0.034) (1.4 (1.36C1.44) weeks; P 0.001] and an Operating-system gain of 3.7 months [6.4 (95% CI: 5.4C7.4) 2.7 (2.3C3.1) weeks, P0.001], set alongside the rest of individuals. Discussion Several research Epirubicin Hydrochloride distributor have retrospectively looked into cohorts of SCLC individuals regarding prognostic elements of 1st- and second-line therapy, and some reports have examined more complex treatment lines. Nevertheless, since there’s a lack of medical standards for advanced SCLC, it is very important.