Amrubicin for relapsed small-cell lung cancer: a systematic review and meta-analysis of 803 patients

Sci Rep. 2016 Jan 11:6:18999. doi: 10.1038/srep18999.

Abstract

Currently, amrubicin is permitted for relapsed small-cell lung carcinoma (SCLC) only in Japan. The efficacy and adverse effects of amrubicin as reported by previous studies varied greatly. The inclusion criterion was a prospective study that was able to provide data for efficacy and safety by the AMR single agent regimen as second-line chemotherapy for a patient with SCLC. Binary data were meta-analyzed with the random-model generic inverse variance method. We included nine articles consisted of 803 patients. The pooled three-, six-, and nine-month progression-free survival were 63% (95% CI 57-69%, I(2) = 53%), 28% (95% CI 21-35%, I(2) = 71%), and 10% (95% CI 6-14%, I(2) = 41%), respectively. The pooled six-, 12-, and 18-month overall survival were 69% (95% CI 61-78%, I(2) = 83%), 36% (95% CI 28-44%, I(2) = 80%), and 15% (95% CI 8-21%, I(2) = 81%), respectively. Amrubicin seemed much more beneficial for Japanese patients. However, compared to the efficacy of topotecan presented in a previous meta-analysis, amrubicin may be a better treatment option than topotecan for both Japanese and Euro-American. Adverse effects by amrubicin were almost exclusively observed to be hematological. Notably, grade III/IV neutropenia incidence was 70% and febrile neutropenia incidence was 12%.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anthracyclines / administration & dosage*
  • Anthracyclines / adverse effects
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Asian People
  • Humans
  • Japan
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / ethnology
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Neutropenia / etiology
  • Neutropenia / pathology
  • Recurrence
  • Small Cell Lung Carcinoma / drug therapy*
  • Small Cell Lung Carcinoma / ethnology
  • Small Cell Lung Carcinoma / mortality
  • Small Cell Lung Carcinoma / pathology
  • Survival Analysis
  • Topotecan / administration & dosage*
  • Topotecan / adverse effects
  • Treatment Outcome
  • White People

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Topotecan
  • amrubicin