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Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease

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Abstract

Purpose

To investigate the safety of intravenous topotecan monotherapy for relapsed small cell lung cancer (SCLC) patients with pre-existing interstitial lung disease (ILD).

Methods

A total of 77 patients who received topotecan for the treatment of relapsed SCLC between April 2007 and April 2014 were reviewed. Patients with pre-existing ILD were identified using the pretreatment chest computed tomography. The safety of intravenous topotecan for SCLC patients with ILD was retrospectively examined, particularly focusing on topotecan-induced acute exacerbation of ILD (AE-ILD).

Results

Twenty-three patients were identified as having pre-existing ILD [median age 74 (range 55–85) years; 21 men]. At the first topotecan administration, two-thirds (65.2 %) had an Eastern Cooperative Oncology Group performance status 0 or 1. Topotecan was administered intravenously as second-line (n = 11) or later chemotherapy (n = 12). The median number of treatment cycles was two (range 1–7). The most common adverse events with grade 3 or 4 were neutropenia in 13 patients (56.5 %) and thrombocytopenia in 10 patients (43.5 %). Febrile neutropenia was observed in six patients (26.1 %) and resulted in one death. AE-ILD occurred in five patients (21.7 %; 95 % confidence interval 4.9–38.5 %) 5–18 days after the last administration of topotecan and was fatal in three cases.

Conclusions

Intravenous topotecan monotherapy can be unsafe for relapsed SCLC patients with pre-existing ILD. Clinicians should be cautious regarding topotecan-induced AE-ILD as a lethal complication.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Respiratory Disease Center, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu, 433-8558, Japan

    Yasunori Enomoto, Hirotsugu Hasegawa, Yuichi Ozawa, Takashi Matsui & Koshi Yokomura

  2. Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Naoki Inui

  3. Department of Respiratory Medicine, Iwata City Hospital, Iwata, Japan

    Shiro Imokawa

  4. Department of Clinical Oncology, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Masato Karayama

  5. Second Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Yasunori Enomoto, Naoki Inui, Masato Karayama & Takafumi Suda

Authors
  1. Yasunori Enomoto
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  2. Naoki Inui
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  3. Shiro Imokawa
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  4. Masato Karayama
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  5. Hirotsugu Hasegawa
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  6. Yuichi Ozawa
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  7. Takashi Matsui
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  8. Koshi Yokomura
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  9. Takafumi Suda
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Correspondence to Yasunori Enomoto.

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Enomoto, Y., Inui, N., Imokawa, S. et al. Safety of topotecan monotherapy for relapsed small cell lung cancer patients with pre-existing interstitial lung disease. Cancer Chemother Pharmacol 76, 499–505 (2015). https://doi.org/10.1007/s00280-015-2816-6

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  • DOI: https://doi.org/10.1007/s00280-015-2816-6

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