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Lower optimal dose of amrubicin for relapsed small-cell lung cancer: a retrospective study

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Abstract

Background

Amrubicin (AMR) is one of the most active agents for small-cell lung cancer (SCLC). However, hematologic toxicity and infection at a commonly used dose (40 mg/m2) is problematic; the optimal dose remains undetermined.

Patients and methods

To evaluate the optimal dose of AMR in terms of efficacy and safety, we reviewed consecutive data on patients with relapsed SCLC who received AMR at doses of 40, 35, and 30 mg/m2 (on days 1–3) at Nippon Medical School Hospital between October 2010 and November 2021.

Results

We reviewed the data of 86 patients (20, 45, 27 who received AMR doses of 40, 35, 30 mg/m2, respectively) according to our study criteria. For patients  ≥ 75 years, the proportion who received second-line treatment tended to be higher in the 30–35 mg/m2 group. Objective response rates were 37/46/35%, median progression-free survival (PFS) were 3.0/4.7/3.2 months, and median overall survival (OS) were 7.8/16.3/8.0 months, respectively. Grade 4 neutropenia occurred in 58/39/31% of patients, which was higher for the 40 mg/m2 group. The incidence of febrile neutropenia did not differ between groups. Multivariate analysis identified the AMR dose was not associated with longer PFS and OS.

Conclusion

Treatment with AMR between 30 and 35 mg/m2 showed relatively mild hematologic toxicity compared with AMR at 40 mg/m2, without any significant difference in efficacy. Lower dose of AMR for relapsed SCLC could be a promising treatment option.

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Acknowledgements

The authors thank the study participants, who provided clinicopathological data for our analysis.

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Authors and Affiliations

  1. Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan

    Shinji Nakamichi, Kaoru Kubota, Fenfei Zou, Anna Hayashi, Natsuki Takano, Naomi Onda, Masaru Matsumoto, Akihiko Miyanaga, Rintaro Noro & Masahiro Seike

Authors
  1. Shinji Nakamichi
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  2. Kaoru Kubota
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  3. Fenfei Zou
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  4. Anna Hayashi
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  5. Natsuki Takano
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  6. Naomi Onda
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  7. Masaru Matsumoto
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  8. Akihiko Miyanaga
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  9. Rintaro Noro
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  10. Masahiro Seike
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Corresponding author

Correspondence to Shinji Nakamichi.

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Conflict of interest

Dr. Kubota received research fund from Nihon Kayaku, AstraZeneca and payment or honoraria for lectures and presentations from Chugai Pharmaceutical. Dr. Seike received payment or honoraria for lectures and presentations from AstraZeneca, Chugai Pharmaceutical, Taiho Pharmaceutical, MSD, Ono Pharmaceutical, Bristol–Myers Squibb, Eli Lilly Japan, Takeda Pharmaceutical, Nihon Kayaku, Nippon Boehringer Ingelheim, Pfizer, Kyowa–Hakko Kirin, and Novartis. No other disclosures were reported.

Ethics statement

The protocol of this study was approved by the Institutional Review Board of Nippon Medical School Hospital (B-2022-538).

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Nakamichi, S., Kubota, K., Zou, F. et al. Lower optimal dose of amrubicin for relapsed small-cell lung cancer: a retrospective study. Int J Clin Oncol 28, 872–879 (2023). https://doi.org/10.1007/s10147-023-02343-9

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  • DOI: https://doi.org/10.1007/s10147-023-02343-9

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