[Prognostic factors and response of chemotherapy including amrubicin in small cell lung cancer patients].

Objective: To evaluate the response, toxicity and prognostic factors of amrubicin in the therapy of small cell lung cancer (SCLC).

Methods: Thirty-one SCLC patients treated with amrubicin in Beijing Cancer Hospital from Dec.2008 to Apr.2013, including 21 males and 10 females, aged from 32 to 75 years, were enrolled in this study. Amrubicin was injected intravenously with 40 mg/m² d1-3, Q21 d or combined with cisplatin 60 mg/m² d1, Q 21 d. The first line chemotherapy regimens included amrubicin plus cisplatin in 11 cases, etopside plus platin in 18 cases and other drugs in 2 cases. The second and more line chemotherapy treatments included amrubicin in 20 cases, topotican in 14 cases and others in 28 cases. SPSS 16.0 statistical analysis software was used to analyze the clinical characteristics and survivals.

Results: The median progression free survival (PFS) of patients receiving amrubicin plus cisplatin and single amrubicin were 7.5 months (95% CI: 6.2 to 8.8 ) and 4.1 months (95% CI:1.2 to 7.0) respectively (P= 0.090). There were 16 refractory patients whose disease progressed within 3 months after first line chemotherapy and 15 sensitive patients who had tumor progression after more than 3 months; the median survival time (MST) were 14.2 months (95% CI 11.1-17.3) and 21.3 months (95% CI 15.7-26.9) respectively (P= 0.018). Patients treated with amrubicin plus cisplatin as first line therapy had a prolonged median PFS compared with etopside plus platin, which were 7.5 months (95% CI:6.2-8.8) vs. 4.6 months (95% CI:1.7-7.5) (P= 0.055). Patients received amrubicin, topotican or other drugs as second or more line therapy had median PFS of 4.1 months (95% CI: 1.2-7.0), 1.4 months (95% CI: 0.8-2.0) and 1.6 months (95% CI:1.2-1.9) respectively (P= 0.013), while the median PFS was 5.6 months (95% CI: 2.0-9.2), 1.4 months (95% CI: 0.6-2.2) and 1.4 months (95% CI: 0.8-2.0) (P= 0.005 and 0.003) in refractory patients.

Conclusions: Amrubicin as second or more line treatment was shown to be an effective and safe drug for SCLC patients with a significant survival benefit compared with other drugs, especially in refractory patients. It suggested that amrubicin might be one of the preferred therapies for refractory SCLC.