P29. Oral topotecan in small cell lung cancer: treatment related side effects
Filip Popovic1, Miroslav Samarzija1,2, Suzana Kukulj1, Gzim Redzepi1, Mihovil Roglic1, Davorka Mursic1, Branka Cucevic1, Sanja Plestina1, Marko Jakopovic1,2
Background: Lung cancer is the most common tumor in men and the second most common tumor in women according to the latest data available from the Croatian National Cancer Registry. Approximately 20% of all lung cancers are categorized as small cell lung cancer (SCLC). Topotecan is recommended as second-line chemotherapy in treatment of SCLC. Topotecan can be administrated orally with the same effectiveness as parenteral application.
Methods: The aim of this study was to determine toxicity of oral topotecan and to establish the frequency of drug related admissions.
Results: The study included 48 patients, 13 woman and 35 men with SCLC, ranging from 45 to 72 years, with the mean age being of 60.5 years, that referred to University Hospital Center Zagreb, from January 2012 to June 2014. Included patients had ECOG performance status of 0 or 1. Topotecan was administrated every 21 day, at the dose of 2.3 mg/m2/day, during 5 days. Average number of courses received was 2.7. Of all included patients 18 of them (37.5%) were admitted to hospital because of adverse events related to topotecan administration. The majority of patient hospitalizations (11 patients, 22.9%) was due to febrile neutropenia. Other reasons for hospitalization were severe diarrhea in 4 patients (8.4%), pneumonia in one patient (2.1%), severe pancytopenia in one patient (2.1%) and severe electrolyte imbalance in one patient (2.1%). Anemia that needed transfusion occurred in 16 patients (33.3%), with grade 3 or 4 anemia occurring in 13 of them (27.1%). Grade 3 or 4 thrombocytpenia occurred in six patients (12.6%) and all of them were treated with transfusions. Sixteen patients (33.3%) received granulocyte colony stimulating factor for treatment of neutropenia. Grade 3 or 4 neutropenia occurred in 14 patients (29.1%). Of other, non-hematologic adverse effects the most serious was grade 3 or 4 diarrhea that occurred in 4 patients (8.4%).
Conclusions: Although the route of administration makes oral topotecan a more convenient treatment method, our results show high rates of myelotoxicity during therapy, what is in concordance with the majority of previous studies.
Keywords: Small cell lung cancer (SCLC); topocetan
doi: 10.3978/j.issn.2218-6751.2014.AB041
