Thoracic Cancer (Dec 2023)

Safety and efficacy of amrubicin with primary prophylactic pegfilgrastim as second‐line chemotherapy in patients with small cell lung cancer

  • Motoki Sekikawa,
  • Haruyasu Murakami,
  • Meiko Morita,
  • Kosei Doshita,
  • Keita Miura,
  • Hiroaki Kodama,
  • Noboru Morikawa,
  • Yuko Iida,
  • Nobuaki Mamesaya,
  • Haruki Kobayashi,
  • Ryo Ko,
  • Kazushige Wakuda,
  • Akira Ono,
  • Hirotsugu Kenmotsu,
  • Tateaki Naito,
  • Hirofumi Chiba,
  • Toshiaki Takahashi

DOI
https://doi.org/10.1111/1759-7714.15140
Journal volume & issue
Vol. 14, no. 35
pp. 3475 – 3482

Abstract

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Abstract Background Amrubicin (AMR) regimens have shown efficacy as second‐line treatment in patients with small cell lung cancer (SCLC); however, adverse events such as febrile neutropenia (FN) sometimes preclude their use. Further, the safety and efficacy of AMR with primary prophylactic pegfilgrastim (P‐PEG) have not been sufficiently evaluated. In this study, we evaluated the safety and efficacy of AMR with or without P‐PEG as second‐line chemotherapy for SCLC. Methods We retrospectively reviewed patients with SCLC who received AMR as second‐line chemotherapy at Shizuoka Cancer Center, between December 2014 and November 2021. Based on presence/absence of P‐PEG in their regimen, patients (n = 60) were divided into P‐PEG (n = 21) and non‐P‐PEG groups, and their clinical outcomes were evaluated. Results Median of AMR treatment cycles was five (range: 1–39 cycles) in P‐PEG group and four (range: 1–15 cycles) in non‐P‐PEG group. The incidence of FN (4.8% vs. 30.8%; p = 0.02) and AMR dose reduction because of adverse events (4.8% vs. 25.6%; p = 0.08) were lower in the P‐PEG group than in the non‐P‐PEG group. The objective response rates were 52.4% and 30.8%, and median progression‐free and overall survival were 4.7 and 3.0 months, and 9.6 and 6.8 months, in the P‐PEG and non‐P‐PEG groups, respectively. Conclusions AMR with P‐PEG as second‐line chemotherapy for SCLC reduced the incidence of FN at a maintained AMR dose intensity and was associated with favorable tumor responses and survival outcomes. P‐PEG should be considered for patients treated with AMR for SCLC including refractory relapsed SCLC.

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