Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts
Panje, C. M.
Blackhall, Fiona H
Paz Ares, L.
de Marinis, F.
De Ruysscher, D.
Putora, P. M.
AffiliationDepartment of Medical Oncology/Hematology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
MetadataShow full item record
AbstractOBJECTIVES: Stage IV small cell lung cancer (SCLC) is associated with short survival and progression after first-line systemic therapy frequently occurs within months. Although topotecan is approved for second-line treatment, its efficacy is limited, and treatment heterogeneity exists. MATERIAL AND METHODS: The decision-making patterns for second line treatment of 13 European medical oncologists with expertise in SCLC were analyzed. RESULTS: The two criteria most relevant to decision-making were the performance status and the interval of recurrence since first-line treatment. With an interval of less than 3 months since the end of first-line chemotherapy, 62 % of the experts recommended cyclophosphamide, doxorubicin and vincristine (CAV) for fit patients and 54 % recommended topotecan for unfit patients. For an interval of more than 6 months, a clear consensus for a re-challenge with a platinum doublet was achieved (92 %). However, there was no consensus on the second-line therapy with an interval of 3-6 months since the end of first-line therapy. CONCLUSION: Real world practice may differ from recommendations in general guidelines and cannot always be directly derived from trial results as other factor such as habits, patient's preference, convenience or costs have to be factored in.
CitationM. Fruh, C. M. Panje, M. Reck et al. Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts. Lung Cancer. 2020;146:6-11.
- Systematic Review of topotecan (Hycamtin) in relapsed small cell lung cancer.
- Authors: Riemsma R, Simons JP, Bashir Z, Gooch CL, Kleijnen J
- Issue date: 2010 Aug 17
- Topotecan in the treatment of recurrent small cell lung cancer: an update.
- Authors: Ardizzoni A
- Issue date: 2004
- Topotecan: a review of its efficacy in small cell lung cancer.
- Authors: Ormrod D, Spencer CM
- Issue date: 1999 Sep
- Topotecan versus cyclophosphamide, doxorubicin, and vincristine for the treatment of recurrent small-cell lung cancer.
- Authors: von Pawel J, Schiller JH, Shepherd FA, Fields SZ, Kleisbauer JP, Chrysson NG, Stewart DJ, Clark PI, Palmer MC, Depierre A, Carmichael J, Krebs JB, Ross G, Lane SR, Gralla R
- Issue date: 1999 Feb
- The clinical effectiveness and cost-effectiveness of topotecan for small cell lung cancer: a systematic review and economic evaluation.
- Authors: Loveman E, Jones J, Hartwell D, Bird A, Harris P, Welch K, Clegg A
- Issue date: 2010 Mar