Reinitiating Chemotherapy beyond Progression after Maintenance Immunotherapy in Extensive-Stage Small-Cell Lung Cancer.

Roxana-Andreea Rahnea-Nita, Radu-Valeriu Toma, Valentin Titus Grigorean, Ionuţ Simion Coman, Violeta Elena Coman, Iancu Emil Pleşea, Anwar Erchid, Gabriel-Petre Gorecki, Gabriela Rahnea-Nita
Author Information
  1. Roxana-Andreea Rahnea-Nita: 8th Clinical Department-Radiology, Oncology and Hematology, Faculty of Medicine, "Carol Davila" University of Medicine and Phamacy, 020021 Bucharest, Romania.
  2. Radu-Valeriu Toma: 8th Clinical Department-Radiology, Oncology and Hematology, Faculty of Medicine, "Carol Davila" University of Medicine and Phamacy, 020021 Bucharest, Romania.
  3. Valentin Titus Grigorean: 10th Clinical Department-General Surgery, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  4. Ionuţ Simion Coman: 10th Clinical Department-General Surgery, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania. ORCID
  5. Violeta Elena Coman: 10th Clinical Department-General Surgery, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
  6. Iancu Emil Pleşea: Department of Histopathology, "Bagdasar-Arseni Clinical Emergency Hospital", 041915 Bucharest, Romania.
  7. Anwar Erchid: Department of General Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, 041915 Bucharest, Romania.
  8. Gabriel-Petre Gorecki: Department of Anesthesia and Intensive Care, Faculty of Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania. ORCID
  9. Gabriela Rahnea-Nita: Department of Oncology-Palliative Care, "Sf. Luca" Chronic Diseases Hospital, 041915 Bucharest, Romania.

Abstract

: Small-cell lung cancer (SCLC) is an aggressive form of cancer with a poor prognosis. The two-year survival rate is 8% of all cases. : We present the case of a male patient who was 50 years old at the time of diagnosis in May 2022. He was diagnosed with extensive-stage small-cell lung cancer, treated with immunotherapy in combination with chemotherapy (Durvalumab in combination with Etoposide plus Carboplatin) as a first-line treatment, followed by maintenance immunotherapy. In December 2023, a PET-CT scan revealed progressive disease with multiple metastases. Chemotherapy was reinitiated with Etoposide plus Cisplatin in January 2024. After two cycles of chemotherapy, the patient developed post-chemotherapy anemia, for which treatment with Epoetinum alpha was initiated. Chemotherapy was continued for another five cycles, until May 2024, with the maintenance of hemoglobin at a level within 9.9 mg/dL-11 mg/dL. Upon assessment at the end of May 2024, the patient presented an ECOG = 2 performance status, with a moderate general state, moderate-intensity fatigue, no pain, no anxiety or depression and no dyspnea. : Reinitiating chemotherapy after the failure of maintenance immunotherapy may be an option in patients with SCLC. Epoetinum allows oncological treatment by preventing chemotherapy-induced anemia.

Keywords

References

  1. ESMO Open. 2022 Apr;7(2):100408 [PMID: 35279527]
  2. Cancer Manag Res. 2018 Nov 21;10:6039-6047 [PMID: 30538553]
  3. Curr Treat Options Oncol. 2022 Feb;23(2):268-294 [PMID: 35226309]
  4. Onco Targets Ther. 2023 Aug 02;16:657-671 [PMID: 37551311]
  5. Life (Basel). 2023 May 30;13(6): [PMID: 37374062]
  6. J Clin Oncol. 2005 Dec 20;23(36):9377-86 [PMID: 16361638]
  7. Tuberc Respir Dis (Seoul). 2024 May 14;: [PMID: 38749491]
  8. Curr Oncol. 2019 Jun;26(3):e372-e384 [PMID: 31285682]
  9. Health Qual Life Outcomes. 2003 Aug 01;1:29 [PMID: 12914662]
  10. Clin Breast Cancer. 2005 Jun;6(2):132-42 [PMID: 16001991]
  11. Mayo Clin Proc. 2019 Aug;94(8):1599-1622 [PMID: 31378235]
  12. J Psychosom Res. 2002 Feb;52(2):69-77 [PMID: 11832252]
  13. Oncology. 2020;98(11):749-754 [PMID: 32663833]
  14. Pulm Ther. 2023 Sep;9(3):435-450 [PMID: 37310567]
  15. Immunotherapy. 2021 Oct;13(14):1165-1177 [PMID: 34261336]
  16. Semin Oncol. 2002 Jun;29(3 Suppl 8):81-7 [PMID: 12082659]
  17. Acta Psychiatr Scand. 1983 Jun;67(6):361-70 [PMID: 6880820]
  18. J Clin Oncol. 2001 Jun 1;19(11):2865-74 [PMID: 11387359]
  19. Nat Rev Dis Primers. 2021 Jan 14;7(1):3 [PMID: 33446664]
  20. Oncotarget. 2023 May 26;14:517-525 [PMID: 37235814]
  21. J Pain Symptom Manage. 2017 Mar;53(3):630-643 [PMID: 28042071]
  22. J Palliat Care. 1991 Summer;7(2):6-9 [PMID: 1714502]
  23. J Thorac Dis. 2023 Jul 31;15(7):3554-3556 [PMID: 37559596]
  24. J Thorac Oncol. 2023 Jan;18(1):31-46 [PMID: 36243387]
  25. Oncotarget. 2017 Aug 08;8(53):91795-91802 [PMID: 29207685]
  26. Cancer. 2000 May 1;88(9):2164-71 [PMID: 10813730]
  27. Cancer Treat Res. 2016;170:301-22 [PMID: 27535400]
  28. Cancers (Basel). 2021 May 21;13(11): [PMID: 34063886]
  29. Acta Endocrinol (Buchar). 2016 Jul-Sep;12(3):355-361 [PMID: 31149114]
  30. Front Oncol. 2022 Apr 14;12:840783 [PMID: 35494084]
  31. Pharmacol Ther. 2017 Dec;180:16-23 [PMID: 28579387]
  32. J Pers Med. 2024 Jan 12;14(1): [PMID: 38248787]
  33. JTO Clin Res Rep. 2021 Dec 10;3(1):100266 [PMID: 35024640]
  34. J Med Assoc Thai. 2007 Jun;90(6):1082-8 [PMID: 17624200]
  35. Cancers (Basel). 2024 Jan 05;16(2): [PMID: 38254746]
  36. Front Oncol. 2023 Sep 18;13:1191855 [PMID: 37795434]

MeSH Term

Humans
Male
Small Cell Lung Carcinoma
Middle Aged
Lung Neoplasms
Immunotherapy
Antineoplastic Combined Chemotherapy Protocols
Disease Progression
Etoposide
Epoetin Alfa

Chemicals

Etoposide
Epoetin Alfa

Word Cloud

Created with Highcharts 10.0.0cancerimmunotherapychemotherapy:lungpatientMaytreatmentmaintenanceChemotherapy2024EpoetinumSCLCsmall-cellcombinationEtoposideplusfirst-linecyclesanemiaalpha9ReinitiatingSmall-cellaggressiveformpoorprognosistwo-yearsurvivalrate8%casespresentcasemale50yearsoldtimediagnosis2022diagnosedextensive-stagetreatedDurvalumabCarboplatinfollowedDecember2023PET-CTscanrevealedprogressivediseasemultiplemetastasesreinitiatedCisplatinJanuarytwodevelopedpost-chemotherapyinitiatedcontinuedanotherfivehemoglobinlevelwithinmg/dL-11mg/dLUponassessmentendpresentedECOG=2performancestatusmoderategeneralstatemoderate-intensityfatiguepainanxietydepressiondyspneafailuremayoptionpatientsallowsoncologicalpreventingchemotherapy-inducedbeyondProgressionMaintenanceImmunotherapyExtensive-StageSmall-CellLungCancerreinitiating

Similar Articles

Cited By