A pilot study of adjuvant chemotherapy with irinotecan and cisplatin for completely resected high-grade pulmonary neuroendocrine carcinoma (large cell neuroendocrine carcinoma and small cell lung cancer) |
| |
| Authors: | Hirotsugu Kenmotsu Seiji Niho Takeo Ito Yuichi Ishikawa Masayuki Noguchi Hirohito Tada Ikuo Sekine Shun-ichi Watanabe Masahiro Yoshimura Nobuyuki Yamamoto Fumihiro Oshita Kaoru Kubota Kanji Nagai |
| |
| Affiliation: | 1. Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan;2. Division of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan;3. Division of Pulmonary Medicine, Kuroki Memorial Hospital, Oita, Japan;4. Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan;5. Department of Pathology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;6. Department of General Thoracic Surgery, Osaka City General Hospital, Osaka, Japan;g Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan;h Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan;i Division of Thoracic Surgery, Hyogo Cancer Center, Hyogo, Japan;j Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan;k Medical Oncology Division, Nippon Medical School Hospital Cancer Center, Tokyo, Japan;l Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan |
| |
| Abstract: | BackgroundLarge cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC) are recognized as high-grade neuroendocrine carcinomas (HGNEC) of the lung. In patients with completely resected HGNEC, platinum-based adjuvant chemotherapy may be considered. However, the optimum chemotherapy regimen has not been determined. We conducted a multicenter single-arm phase II trial to evaluate irinotecan and cisplatin in postoperative adjuvant chemotherapy for HGNEC patients.Patients and methodsPatients with completely resected stage I–IIIA HGNEC received four cycles of irinotecan (60 mg/m2, day 1, 8, 15) plus cisplatin (60 mg/m2, day 1). This regimen was repeated every 4 weeks. The primary endpoint was the rate of completion of chemotherapy (defined as having undergone three or four cycles), and secondary endpoints were the rate of 3-year relapse-free survival (RFS), rate of 3-year survival and toxicities.ResultsForty patients were enrolled between September 2007 and April 2010. Patients’ characteristics were: median age (range) 65 [45–73] years; male 85%; ECOG-PS 1 60%; LCNEC 57% and SCLC 43%; stage IA/IB/IIB/IIIA 32/35/8/5%; 95% received lobectomy. The rate of completion of chemotherapy was 83% (90% C.I.; 71–90%). The rate of overall survival at 3 years was estimated at 81%, and that of RFS at 3 years was 74%. The rates of overall survival and RFS at 3 years were 86 and 74% among 23 LCNEC patients, and 74 and 76% among 17 SCLC patients, respectively. Nineteen patients (48%) experienced grade 3 or 4 neutropenia, but only five patients (13%) developed febrile neutropenia. Two patients (5%) developed grade 3 diarrhea, and four patients (10%) had grade 3 nausea. No treatment-related deaths were observed in this study. All 40 specimens were also diagnosed as HGNEC by central pathological review.ConclusionsThe combination of irinotecan and cisplatin as postoperative adjuvant chemotherapy was feasible and possibly efficacious for resected HGNEC. |
| |
| Keywords: | Lung cancer High-grade neuroendocrine carcinoma Small cell carcinoma Large cell neuroendocrine carcinoma Adjuvant chemotherapy |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
