The efficacy of amrubicin on central nervous system metastases originating from small-cell lung cancer: a case series of eight patients
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Background Central nervous system (CNS) metastases caused by small-cell lung cancer (SCLC) are incurable and therefore fatal. Although such metastases are usually treated with chemotherapy or radiotherapy, their sensitivity to these treatment measures is unclear. Amrubicin appears to be a promising agent for relapsed SCLC, but its effectiveness in CNS metastases originating from SCLC is unknown. Methods Between April 2002 and December 2009, 110 SCLC patients with CNS metastasis were treated at Shizuoka Cancer Center. Of these, we retrospectively reviewed 8 consecutive cases with CNS metastases originating from relapsed SCLC that were treated with amrubicin as a second-line therapy. Results We recorded three sensitive relapses and five refractory cases. Amrubicin yielded a CNS response rate of 50 % (2 partial responses and 2 complete response; 95 % CI, 21.5–78.5 %) and the disease control rate for CNS lesions was 87.5 % (95 % CI, 52.9–97.8 %). All of the sensitive relapse patients achieved a partial response. The median time to progression for CNS metastases was 150.5 days (95 % CI, 9–171 days), and the median survival time from the start of amrubicin administration was 230.5 days (95 % CI, 89–619 days). We also report a dramatic improvement in one patient’s radiological result of intramedullary spinal cord metastasis and alleviation of her symptoms following amrubicin monotherapy including this case series. Conclusions The results of this study suggest that amrubicin is active in patients with CNS metastases originating from SCLC.
KeywordsSmall-cell lung cancer Chemotherapy Amrubicin Central nervous system metastases
Central nervous system
Small-cell lung cancer
Time to progression of CNS metastases
Intramedullary spinal cord metastasis
Magnetic resonance imaging
Sources of support: This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labor, and Welfare of Japan. We appreciate Ms. Yuka Matsui for her technical assistance of manuscript submission.
The authors declare that they have no competing interests.
SM and KK conceived of the study and contributed to writing and editing the report. RK, HA, AO, TS, AT and YN participated in data acquisition and interpretation. HK, TT and ME advised on clinical matters and the interpretation of the data and contributed to the writing of the report and helped to draft the manuscript. HM and TN helped to perform the statistical analysis. NY provided overall project management. All authors read and approved the final manuscript.
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