Second Line Treatment Choice in Extensive Small Lung Cancer

Abstract

Objectives: Small cell lung cancer (SCLC) is approximately 15% of all lung cancer. Topotecan is the preferred chemotherapy regimen in second-line treatment, but toxicity might be limiting to use in clinical routine. Physicians had more experience on weekly paclitaxel due to its easy access and good responses in many cancers. The present study aimed to examine the management of patients treated with topotecan and weekly paclitaxel as second-line treatment of SCLC. Methods: Patients were divided into two groups due to second-line treatment. The primary endpoint of this study was progression-free survival and overall survival. The secondary endpoint was overall response rate and disease control rate. Results: The median PFS was 4.5 months (Topotecan 3.7 vs. Paclitaxel 5.5, HR = 0.34, 95% CI: 0.30-0.64, p=0.000) and the median OS was 11 months (Topotecan 9.5 vs. Paclitaxel 12.7, HR = 0.25, 95% CI: 0.20-0.45, p=0.000). ORR was 10.2 % in topotecan group and 20.3%% in paclitaxel group (p: 0.047). DCR was 15.5% in patients treated with topotecan and 28.8% in paclitaxel group (p=0.033). Conclusion: The present study compared the currently preferred regimen topotecan with weekly paclitaxel and resulted in better survival and response rates with lower toxicity profile.