According to the results of a study published in the Journal of Clinical Oncology, patients with relapsed small cell lung cancer survived longer if they were treated with the oral chemotherapy drug Hycamtin® (topotecan) than if they received no further chemotherapy.

Small cell lung cancers account for 20–25% of all lung cancers and are primarily diagnosed in smokers or former smokers. They differ from other types of lung cancer in that they spread very quickly throughout the body via the blood and lymphatic system.

When lung cancer has been detected or has returned following an initial treatment with surgery, radiation, and/or chemotherapy, it is referred to as recurrent or relapsed.

Historically, patients experiencing a recurrence of small cell lung cancer have had few treatment options. Recently, several newer chemotherapeutic drugs have demonstrated a substantial ability to kill small cell lung cancer cells in patients with recurrent cancer. Developing and exploring single or multi-agent chemotherapy agents as a treatment approach for patients with recurrent or relapsed small cell lung cancer is an area of active investigation.

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To compare treatment with best supportive care (care to relieve symptoms) plus the oral chemotherapy drug Hycamtin to treatment with best supportive care alone, researchers in Italy conducted a Phase III clinical trial among 141 patients with relapsed small cell lung cancer. Because half the study participants were assigned to receive best supportive care alone (without additional chemotherapy), the study was limited to patients who were not considered to be candidates for standard intravenous chemotherapy.

  • Among patients treated with best supportive care alone, half survived for longer than 14 weeks, whereas among patients treated with best supportive care and Hycamtin, half survived for longer than 26 weeks.
  • Symptom control was better among patients treated with best supportive care and Hycamtin than among patients treated with best supportive care alone.
  • The most common serious side effects of Hycamtin were low blood cell counts. Grade 4 neutropenia (low white blood cell count) developed in 33% of patients treated with Hycamtin.

The researchers conclude that chemotherapy with oral Hycamtin improves the survival of patients with relapsed small cell lung cancer.

Reference: O’Brien MER, Ciuleanu T-E, Tsekov H et al. Phase III Trial Comparing Supportive Care Alone with Supportive Care with Oral Topotecan in Patients with Relapsed Small-cell Lung Cancer. Journal of Clinical Oncology. 2006;24:5441-5447.

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