TY  - JOUR
AU  - von Eiff, Damian
AU  - Bozorgmehr, Farastuk
AU  - Chung, Inn
AU  - Bernhardt, Denise
AU  - Rieken, Stefan
AU  - Liersch, Stephan
AU  - Muley, Thomas
AU  - Kobinger, Sonja
AU  - Thomas, Michael
AU  - Christopoulos, Petros
AU  - Steins, Martin
PY  - 2020
TI  - Paclitaxel for treatment of advanced small cell lung cancer (SCLC): a retrospective study of 185 patients
JF  - Journal of Thoracic Disease; Vol 12, No 3 (March 23, 2020): Journal of Thoracic Disease
Y2  - 2020
KW  - 
N2  -  Background:  Etoposide-/platinum-based chemotherapy is the standard first-line treatment for extensive- disease small cell lung cancer (SCLC), but responses are short-lived and subsequent options limited. Here, we present our experience with paclitaxel in advanced treatment lines.   Methods:  We retrospectively studied the clinical course of all paclitaxel-treated SCLC patients between 2005 and 2015 in our institution. Prognostic and predictive factors were analyzed by Kaplan-Meier and Cox regression analyses.   Results:  A total of 185 patients [119 men, median age 65 years, median ECOG performance status (PS) 1] were identified. One hundred and sixty-eight patients had extensive disease (ED) at the time of paclitaxel therapy. Paclitaxel was mainly given as third- or fourth-line therapy (93%). The response rate (RR) was 17% and disease control rate (DCR) 28%. Patients reached a median progression-free survival (PFS) of 1.6 (95% CI: 1.4–1.8) months and median overall survival (OS) of 3.3 (95% CI: 2.8–3.9) months. Main toxicities were fatigue (25%) and polyneuropathy (17%). Dose reduction of ≥25% was associated with shorter PFS [1.9 (95% CI: 1.5–2.3)  vs . 1.4 (95% CI: 1.3–1.5) months; P=0.004]. Further independent predictive factors for PFS were gender, age, and hepatic/brain metastases (P vs . 62%), as well as a comparable DCR (29%  vs . 28%), which was associated with prolonged survival (4.5  vs . 3.2 months for refractory cases, P=0.034).   Conclusions:  Paclitaxel has clinically relevant activity in heavily pretreated SCLC. While patients with good PS and no cerebral/hepatic metastases derive the greatest benefit, ECOG PS 2 per se should not be used as a criterion to exclude patients.
UR  - https://jtd.amegroups.org/article/view/35170