Choice of second-line systemic therapy in stage IV small cell lung cancer (SCLC) - A decision-making analysis amongst European lung cancer experts
Blackhall, Fiona H
Paz Ares, L
de Marinis, F
De Ruysscher, D
AffiliationDepartment of Medical Oncology/Hematology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; University of Bern, Bern, Switzerland.
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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. Keywords: Decision making; Objective consensus; Second-line chemotherapy; Small cell lung cancer (SCLC).
CitationFruh M, Panje CM, Reck M, Blackhall F, Califano R, Cappuzzo F, 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.
- Chemotherapy versus best supportive care for extensive small cell lung cancer.
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- Issue date: 2013 Nov 27
- Topotecan: a review of its efficacy in small cell lung cancer.
- Authors: Ormrod D, Spencer CM
- Issue date: 1999 Sep
- Second-Line Therapy of Small-Cell Lung Cancer: Topotecan Compared to a Combination Treatment with Adriamycin, Cyclophosphamide And Vincristine (ACO) - a Single Center Experience.
- Authors: Hagmann R, Hess V, Zippelius A, Rothschild SI
- Issue date: 2015
- 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
- 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