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. 2007 Dec;3(6):1087-95.

Topotecan: An evolving option in the treatment of relapsed small cell lung cancer

Jennifer Garst  1
Affiliations

Topotecan: An evolving option in the treatment of relapsed small cell lung cancer

Jennifer Garst. Ther Clin Risk Manag. 2007 Dec.

Abstract

The topoisomerase I inhibitor topotecan is the only single-agent therapy approved for the treatment of recurrent small cell lung cancer (SCLC). Many patients with recurrent SCLC may be predisposed to treatment-related adverse events because of the presence of comorbidities such as advanced age, renal impairment, or extensive prior therapy. In this setting, disease stabilization is considered a treatment benefit, and quality-of-life effects and toxicity profiles of treatments should be considered. The approved regimen of topotecan 1.5 mg/m² on days 1 to 5 of a 21-day cycle is active and has generally mild nonhematologic toxicity and a well-established hematologic toxicity profile characterized by reversible, manageable, and noncumulative neutropenia. Alternative dosing and treatment schedules may lower the incidence of hematologic toxicities while maintaining antitumor efficacy in this patient population. Therefore, topotecan may provide physicians with an effective and versatile therapeutic option for the treatment of patients with relapsed SCLC.

Keywords: relapsed cancer; review; small cell lung cancer; topotecan.

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Figures

Figure 1
Figure 1
Mechanism of action of topotecan. Copyright © 1997. Reprinted with permission from Rothenberg ML. 1997. Topoisomerase I inhibitors: review and update. Ann Oncol, 8:837–55
Figure 2
Figure 2
Median neutrophil nadirs by treatment course, dose, and granulocyte-colony stimulating factor (G-CSF). After the first course, patients may have received G-CSF or reduced doses of topotecan; some patients may have discontinued topotecan because of myelosuppression. Copyright © 2005. Reprinted with permission from Armstrong DK, Spriggs D, Levin J, et al. 2005. Hematologic safety and tolerability of topotecan in recurrent ovarian cancer and small cell lung cancer: an integrated analysis. Oncologist, 10:686–94
Figure 3
Figure 3
Overall response rates (ORRs) and stable disease (SD) responses to various topotecan treatment regimens.
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