Bendamustine modestly efficacious but well tolerated in SCLC

By Sarah Pritchard, medwireNews Reporter

Patients with relapsed or treatment-resistant small-cell lung cancer (SCLC) can achieve modest survival benefits with few side effects when treated with bendamustine, report US researchers.

The findings indicate its potential use in both a chemoresistant and a chemosensitive SCLC population; however, its improved efficacy and quality of life in comparison with topotecan – the only currently approved treatment for these patients – will need proof from a large phase III trial, notes the team behind the current single-arm phase II study.

A total of 50 NSCLC patients with Eastern Cooperative Oncology Group performance status 0 to 2 NSCLC received 120 mg/m² intravenous bendamustine on the first and second days of the 21-day cycle schedule. Overall, 21 (42%) had received no more than two prior lines of chemotherapy, at least one of which was a platinum-based regimen.

The researchers, led by Leora Horn (Vanderbilt-Ingram Cancer Center, Nashville, Tennessee), assessed disease status via computed tomography scans after every two treatment cycles, evaluated response rate according to the Response Evaluation Criteria in Solid Tumors and graded toxicities using the National Cancer Institute Common Toxicity Criteria.

With a median age of 62 years, 58% of patients had chemosensitive disease, while 42% were chemoresistant. The median time to disease progression in these two groups was 4.2 and 3.4 months, respectively, report the researchers in the Journal of Thoracic Oncology.

Median overall survival among participants was 4.8 months and was slightly longer among those with chemosensitive versus chemoresistant disease, at 5.7 versus 4.1 months. Just over two-thirds (67%) of the cohort had a complete response, partial response and/or stable disease.

While no grade 5 or worse adverse events were reported, 20%, 12% and 12% of patients reported grade 3 or 4 fatigue, dyspnoea and anaemia, respectively. This is comparable with rates of toxicity found in previous studies involving bendamustine, note Horn et al.

The team believes their study population is representative of the majority of patients with relapsed NSCLC and that the results provide the first known evidence of bendamustine's activity in patients with chemotherapy-resistant disease.

“Because of [its] attractive side effect profile, it may be an option for use in patients with relapsed and/or resistant SCLC”, suggest Horn and co-workers.

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