FOLFIRI in advanced platinum-resistant/refractory small-cell lung cancer: a retrospective study

Authors

  • Cyril Roussel-Simonin a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Paul Gougis a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France;b Residual Tumor & Response to Treatment Laboratory, RT2Lab, INSERM, U932 Immunity and Cancer, Institut Curie, Paris, France
  • Donia Lassoued a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Aurore Vozy a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France;c Centre d‘Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, Inserm U1135, Paris, France
  • Marianne Veyri a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France; d Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Institut Universitaire de Cancérologie, CLIP Galilée, Paris, France
  • Laetitia Morardet a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Johanna Wassermann a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Hervé Foka Tichoue a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Loïc Jaffrelot a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Lamia Hassani e Department of Pharmacy, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Alexandre Perrier f Sorbonne Université, Département de Génétique Médicale, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
  • Sebastien Bergeret g Sorbonne Université, Département de Médecine Nucléaire, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
  • Laurent Taillade a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Jean-Philippe Spano a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France; d Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (iPLESP), Institut Universitaire de Cancérologie, CLIP Galilée, Paris, France
  • Luca Campedel a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France
  • Baptiste Abbar a Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié Salpêtrière Hospital, Paris, France; c Centre d‘Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Université, Inserm U1135, Paris, France

DOI:

https://doi.org/10.1080/0284186X.2023.2216339

Keywords:

Small-cell lung cancer, 5-Fluorouracil, Irinotecan, FOLFIRI, Retrospective study

Abstract

  • Background

    Small-cell lung cancer (SCLC) accounts for approximately 15% of lung cancer and is associated with poor prognosis. In platinum-refractory or -resistant SCLC patients, few treatment options are available. Topotecan is one of the standards of care for these patients, however, due to its high toxicity, several different approaches are employed. FOLFIRI (folinate, 5-fluorouracil and irinotecan) is a chemotherapy regimen used in digestive neuroendocrine carcinoma, which shares pathological similarities with SCLC. In this retrospective study, we evaluated the efficacy and safety of FOLFIRI in patients with platinum-resistant/refractory SCLC.

    Methods

    Medical records from all consecutive SCLC patients treated with FOLFIRI in a French University Hospital from 2013 to 2021 were analyzed retrospectively. The primary endpoint was the objective response rate according to RECIST v1.1 or EORTC criteria (ORR); secondary endpoints included duration of response, disease control rate, progression-free survival (PFS), overall survival (OS) and safety profile.

    Results

    Thirty-four patients with metastatic platinum-resistant (n = 14) or -refractory (n = 20) SCLC were included. Twenty-eight were evaluable for response, with a partial response observed in 5 patients for an overall ORR in the evaluable population of 17.9% (5/28) and 14.7% (5/34) in the overall population. The disease control rate was 50% (14/28) in the evaluable population. The median PFS and OS were 2.8 months (95%CI, 2.0–5.2 months) and 5.3 months (95%CI, 3.5–8.9 months), respectively. All patients were included in the safety analysis. Grade 3 or 4 adverse events occurred in 13 (38.2%) patients. The most common grade 3 or 4 adverse events were asthenia, neutropenia, thrombopenia and diarrhea. There was no adverse event leading to discontinuation or death.

    Conclusion

    FOLFIRI showed some activity for platinum-resistant/refractory SCLC in terms of overall response and had an acceptable safety profile. However, caution is needed in interpreting this result. FOLFIRI could represent a potential new treatment for platinum-resistant/refractory SCLC patients. Further prospective studies are needed to assess the benefits of this chemotherapy regimen.

    HIGHLIGHTS

    • FOLFIRI showed some activity for platinum-resistant/refractory SCLC in terms of overall response.

    • FOLFIRI was well-tolerated in platinum resistant/refractory SLCL patients.

    • FOLFIRI could represent a potential new treatment for SCLC, prospective studies are needed.

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Published

2023-06-03

How to Cite

Roussel-Simonin, C., Gougis, P., Lassoued, D., Vozy, A., Veyri, M., Morardet, L., … Abbar, B. (2023). FOLFIRI in advanced platinum-resistant/refractory small-cell lung cancer: a retrospective study. Acta Oncologica, 62(6), 579–586. https://doi.org/10.1080/0284186X.2023.2216339

Issue

Vol. 62 No. 6 (2023): Acta Oncologica

Section

Articles