Cisplatin, etoposide, and irinotecan may be clinically beneficial as a second-line chemotherapy for selected patients with sensitive relapsed small cell lung cancer (SCLC), according to a study published in the journal The Lancet Oncology.1

For this randomized, open-label, phase 3 trial, researchers enrolled 180 patients with SCLC that responded to first-line treatment, but who exhibited evidence of disease relapse or progression at least 90 days after completion of frontline therapy.

At a median follow-up of 22.7 months, median overall survival was 18.2 months (95% CI, 15.7-20.6) with combination chemotherapy, in contrast with 12.5 months (95% CI, 10.8-14.9) for topoteccan (hazard ratio, 0.67; 90% CI, 0.51-0.88; P = .0079), demonstrating a 33% risk of death reduction.

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The findings suggest that this regimen can be considered the standard second-line chemotherapy for specified patients with sensitive relapsed SCLC.

The most common grade 3 to 4 adverse events in the combination arm were neutropenia (83%), anemia (84%), and leukopenia (80%). Ten percent of patients in the combination group and 4% of those in the topotecan group experienced serious adverse events. One and 2 treatment-related deaths occurred in the combination arm and the topotecan arm, respectively.


  1. Goto K, Ohe Y, Shibata T, Seto T, Takahashi T, Kazuhiko N, et al. Combined chemotherapy with cisplatin, etoposide, and irinotecan versus topotecan alone as second-line treatment for patients with sensitive relapsed small-cell lung cancer (JCOG0605): a multicentre, open-label, randomised phase 3 trial [published online ahead of print June 13, 2016]. Lancet Oncol. doi: 10.1016/S1470-2045(16)30104-8.