Topotecan is currently used as second-line therapy for the treatment of small-cell lung cancer. However, some studies have suggested that the doublet of carboplatin and etoposide could have better outcomes. This study aims to compare the efficacy of carboplatin-etoposide and topotecan as a second-line treatment in patients with sensitive relapsed small-cell lung cancer (srSCLC).

This randomized, open-label, phase-3 trial included a total of 162 patients with histologically or cytologically confirmed advanced stage IV srSCLC. The patients were randomly assigned in a 1:1 ratio to receive carboplatin plus etoposide (n=81) or oral topotecan (n=81). The primary outcome of the study was progression-free survival.

During a median follow-up of 22.7 months, the median progression-free survival was 4.7 months in the carboplatin-etoposide group, which was significantly longer than the topotecan group (2.7 months). The most frequently occurring grade 3 & 4 adverse events were neutropenia, thrombocytopenia, anemia, febrile neutropenia, and asthenia. The prevalence of adverse events was higher in the topotecan group. There were two treatment-related deaths in the topotecan group, compared with no treatment-related deaths in the carboplatin-etoposide group.

The research concluded that carboplatin-etoposide combination therapy was associated with better outcomes and safety profile than topotecan in patients with srSCLC.

Ref: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30461-7/fulltext