Abstract
Background: Chemotherapy re-challenge (CTR) is an established clinical approach in some malignancies such as ovarian cancer and small cell lung cancer.
Aims and methods: We screened medical records of 2160 patients (pts) diagnosed with NSCLC and treated with chemotherapy (CT) at our institution, between January 2003 and February 2011.
Results: 10/2160 pts (0.46%) were offered a CTR regimen. The histological subtypes were adenocarcinoma (A) (5 pts), squamous cell carcinoma (3 pts) and not specified (NS) (2 pts). All patients were of good Performance Status (0-1), and the majority without any comorbidities (7/10). All pts were treated with a platinum agent combined with either pemetrexed (6 pts), taxane (3 pts) or gemcitabine (1 pt). 3/10 pts had initially received adjuvant CT and CTR on their first relapse, whereas 7 pts were initially treated for advanced/metastatic disease. In the later 7 pts, partial response (PR) as best response was observed in 6 (85.7%). Median time to progression (TTP) after the initial CT was 9.8 months (range 3.6-37.5). Best responses following CTR were PR in 2 (20%), stable disease (SD) in 2 (20%) and disease progression (PD) in 4 (40%), with 2 pts still on treatment. Median TTP after CRT was 3 months (2.5-12). The 2 pts with PR after CTR (1 A, 1 NS) were both treated with platinum-pemetrexed combination and had both demonstrated PR after the initial CT and TTP of 9 and 17 mo respectively.
Conclusions: CTR is rarely opted in NSCLC likely due to rapid disease progression. The role of CTR is limited and rather unsuccessful. Nevertheless, selected patients might benefit from this approach.
- © 2011 ERS