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. 2024 Oct 1;24(1):1218.
doi: 10.1186/s12885-024-12935-x.

Bi-weekly irinotecan is an effective and convenient regimen in the treatment of relapsed or refractory small cell lung cancer

Feride Yılmaz  1 , Serkan Yaşar  2 , Ömer Denizhan Tatar  3 , Hasan Çağrı Yıldırım  4 , Deniz Can Güven  5 , Arif Akyıldız  2 , Elvin Chalabiyev  2 , Burak Yasin Aktaş  2 , Zafer Arık  2 , Mustafa Erman  2
Affiliations

Bi-weekly irinotecan is an effective and convenient regimen in the treatment of relapsed or refractory small cell lung cancer

Feride Yılmaz et al. BMC Cancer. .

Abstract

Background: Despite initial dramatic responses, metastatic small cell lung cancer (SCLC) invariably recurs. Irinotecan is one of the active agents for patients with recurrent SCLC. In the second line, weekly or three-weekly irinotecan regimens have been adopted, however, the optimal dose and schedule is not defined. In our institution, we use a bi-weekly regimen of irinotecan. In this study, we aimed to investigate the safety and efficacy of the bi-weekly irinotecan in the second- or third-line treatment of SCLC patients.

Methods: The study population consisted of advanced stage SCLC patients who were followed at Hacettepe University Cancer Institute between January 2007 and March 2021 and received salvage irinotecan 180 mg/m2 every two weeks, following progression after platinum-etoposide treatment.

Results: One hundred patients were included. At diagnosis, nineteen patients (19%) had limited stage and 81 patients (81%) had extensive stage SCLC. Objective response rates (ORR) were 44.6% and 46.2% for patients who received irinotecan treatment in second line, and in third line, respectively. Seventeen percent of all the patients had grade 3 and above adverse events during irinotecan treatment. In our study, 45.8% of patients were able to complete at least 6 cycles of irinotecan treatment and 69.8% were able to receive at least 3 cycles of irinotecan treatment without any dose interruption or reduction.

Conclusions: Irinotecan 180 mg/m2 every two weeks appears to be safe and effective in the 2nd- and 3rd-line treatment of advanced stage SCLC. Bi-weekly administration allows G-CSF prophylaxis in between doses, leading to an uninterrupted administration.

Keywords: Bi-weekly administration; Irinotecan; Small cell lung cancer; Tolerability.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Maximum number of cycles given per patient
Fig. 2
Fig. 2
A Progression-free survival (PFS) and (B) overall survival (OS) (n = 100)
Fig. 3
Fig. 3
Progression-free survival (PFS) (A) and overall survival (OS) (B) from the initiation of treatment with 2nd- and 3rd-line irinotecan monotherapy. (section A is demonstrating PFS for 2nd and 3rd line; section B is demonstrating OS for 2nd and 3.rd line treatment respectively)
Fig. 4
Fig. 4
Survival difference between sensitive and refractory relapse in 2nd line irinotecan treatment
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