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Japanese Journal of Clinical Oncology Advance Access originally published online on July 24, 2007
Japanese Journal of Clinical Oncology 2007 37(7):482-486; doi:10.1093/jjco/hym053
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© 2007 Foundation for Promotion of Cancer Research

Effect of Platinum Combined with Irinotecan or Paclitaxel against Large Cell Neuroendocrine Carcinoma of the Lung

Yutaka Fujiwara1, Ikuo Sekine1,, Koji Tsuta2, Yuichiro Ohe1, Hideo Kunitoh1, Noboru Yamamoto1, Hiroshi Nokihara1, Kazuhiko Yamada1 and Tomohide Tamura1

1 Divisions of Internal Medicine and Thoracic Oncology
2 Clinical Laboratory, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan

For reprints and all correspondence: Ikuo Sekine, Divisions of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan. E-mail: isekine{at}ncc.go.jp

Received August 16, 2006; accepted March 3, 2007

Background: The efficacy of chemotherapy in patients with large cell neuroendocrine carcinoma of the lung (LCNEC) remains unclear.

Methods: Of 42 consecutive patients with LCNEC, 22 with measurable disease receiving chemotherapy were enrolled as the subjects of this study. The clinical characteristics and objective responses to chemotherapy in these patients were analysed retrospectively.

Results: The distribution of the disease stage in the patients consisting of 21 males and one female (median age: 67 years; range: 47–78 years) was as follows: stage IIB (n = 1), stage IIIA (n = 1), stage IIIB (n = 5), stage IV (n = 8), and post-operative recurrence (n = 7). Chemotherapy consisted of cisplatin and irinotecan (n = 9), a platinum agent and paclitaxel (n = 6), paclitaxel alone (n = 1), cisplatin and vinorelbine (n = 1), cisplatin and docetaxel (n = 1), and a platinum and etoposide (n = 4). The objective response rate in the 22 patients was 59.1% (95% CI, 38.1–80.1). An objective response was obtained in five of the nine patients receiving irinotecan and five of the seven patients receiving paclitaxel. The progression-free survival, median overall survival and 1-year survival rates were 4.1 months (95% CI, 3.1–5.1), 10.3 months (95% CI, 5.8–14.8) and 43.0% (95% CI, 20.7–65.3), respectively. The median overall survival of the patients treated with irinotecan or paclitaxel was 10.3 months (95% CI, 0–21.8), and the 1-year survival rate of these patients was 47.6% (95% CI, 20.4–74.8).

Conclusion: Our results suggest that irinotecan and paclitaxel may be active against LCNEC.

Key Words: lung cancer • large cell neuroendocrine carcinoma • chemotherapy • irinotecan • paclitaxel


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