Key result
Amrubicin monotherapy was equally tolerated by elderly and younger patients with previously treated lung cancer, showing no significant difference in the incidence of grade 3 or 4 neutropenia (77.3% vs 65.5%, p=0.536).
Why the study?
Is amrubicin monotherapy equally tolerated and effective in elderly patients (≥70 years) compared to younger patients (<70 years) with previously treated lung cancer?
Cohort (n=51)
No
Is amrubicin monotherapy equally tolerated and effective in elderly patients (≥70 years) compared to younger patients (<70 years) with previously treated lung cancer?
Amrubicin monotherapy appears to be equally tolerated and effective in elderly patients compared to younger patients with previously treated lung cancer.
May support amrubicin tolerability in elderly patients with pretreated lung cancer; leaves open efficacy confirmation and randomized validation before practice change.
OBJECTIVE: The novel anthracycline agent amrubicin, has been approved in Japan to treat small and non-small cell lung cancers (SCLC and NSCLC). The present study evaluates the toxicity and effect of amrubicin especially in elderly patients with previously treated lung cancer. PATIENTS AND METHODS: This retrospective study analyzed data from 51 patients (<70 years of age, n=29; > oor =70 years of age, n=22) with lung cancer (NSCLC, n=21; SCLC, n=30) who were treated with amrubicin at our hospital, between July 2003 and October 2009. All patients had recurrent or refractory lung cancer after one or more chemotherapy regimens. We compared the outcomes of patients younger and older than 70 years of age. Amrubicin (30-40 mg/m(2)/day) was infused depending on patient performance status and laboratory data over a period of 5 minutes on days 1-3, with courses repeated at intervals of at least 3 weeks. The dose was modified according to myelosuppression. RESULTS: The mean number of treatment cycles, mean dose and mean interval of amrubicin administration did not significantly differ between patients aged <70 and > or =70 years. The rate of hematological toxicities (> or = Grade 3) also did not significantly differ between the two age groups (leukopenia, 48.3% and 59.1% for age <70 and > or =70 years, p=0.573; neutropenia, 65.5% vs. 77.3%, p=0.536; anemia, 20.7% vs. 22.7%, p=1.000; thrombocytopenia, 13.8% vs. 31.8%, p=0.173). The incidence of grade 2-4 non-hematological toxicities also did not significantly differ between the groups. The response rate of SCLC and disease control rate of NSCLC were similar in the younger and older groups. CONCLUSION: Amrubicin monotherapy might be equally tolerated by elderly and younger patients. Further studies are needed to investigate the benefit of amrubicin monotherapy among elderly patients with previously treated lung cancer.
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Nakao et al. (2010) conducted a cohort in Previously treated lung cancer (NSCLC and SCLC) (n=51). Amrubicin vs. Patients <70 years of age was evaluated on Grade ≥3 neutropenia (p=0.536). Amrubicin monotherapy was equally tolerated by elderly and younger patients with previously treated lung cancer, showing no significant difference in the incidence of grade 3 or 4 neutropenia (77.3% vs 65.5%, p=0.536).
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