Journal Article

The efficacy of amrubicin on central nervous system metastases originating from small-cell lung cancer: a case series of eight patients

Yamamoto, Nobuyuki, Endo, Masahiro, Nakamura, Yukiko, Naito, Tateaki, Kaira, Kyoichi, Ono, Akira, Akamatsu, Hiroaki, Miura, Satoru, Takahashi, Toshiaki, Kenmotsu, Hirotsugu, Murakami, Haruyasu, Shukuya, Takehito, Kaira, Rieko, Tsuya, Asuka

2015

Overview

Summary 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.

• Publisher: Springer US,Springer Nature B.V
• Subject: Aged / Anthracyclines - therapeutic use / Brain - diagnostic imaging / Brain - pathology / Cancer / Cancer therapies / Central Nervous System Neoplasms - diagnostic imaging / Central Nervous System Neoplasms - drug therapy / Central Nervous System Neoplasms - secondary / Chemotherapy / Contrast Media / Disease control / Female / Humans / International / Lung cancer / Lung Neoplasms - pathology / Magnetic resonance imaging / Male / Medical prognosis / Medicine / Medicine & Public Health / Metastasis / Middle Aged / Nervous system / Oncology / Patients / Pharmaceutical industry / Pharmacology/Toxicology / R&D / Radiation therapy / Research & development / Response rates / Short Report / Small Cell Lung Carcinoma - pathology / Spinal cord / Studies / Tomography, X-Ray Computed / Treatment Outcome