ArticleTranslational lung cancer research2025
Doxorubicin paclitaxel in pretreated advanced small-cell lung cancer: a large real-life retrospective study.
Article in Translational lung cancer research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Small-cell lung cancer (SCLC) is a highly aggressive disease with limited treatment options beyond first-line platinum-based chemotherapy. Although various second-line regimens such as topotecan and cyclophosphamide-adriamycin-vincristine have been evaluated, clinical outcomes remain poor, particularly in patients with platinum-resistant or refractory disease. The combination of paclitaxel and doxorubicin showed encouraging results in early-phase trials, but data on its use in real-world settings are lacking. This study aimed to assess the efficacy and safety of this chemotherapy regimen in patients with previously treated SCLC in a real-world clinical setting. Methods: Data were retrospectively collected from all consecutive patients with previously treated SCLC at a single institution in France between 2000 and 2024. Results: A total of 149 patients were included, of whom 79.9% had platinum-resistant or refractory disease at the time of paclitaxel-doxorubicin initiation. The median progression-free survival (PFS) was 2.4 months [95% confidence interval (CI): 2.1-3.8], and the median overall survival (OS) was 5.1 months (95% CI: 4.7-6.0). The objective response rate was 22.2% in the overall population and 27.7% when excluding patients not evaluable for response. The disease control rate was 41.6% including all patients and 52.1% when excluding non-evaluable cases. In multivariable analysis, an Eastern Cooperative Oncology Group performance status of 2-4 compared to 0-1 was associated with shorter PFS [hazard ratio (HR) =1.9, 95% CI: 1.22-2.8, P=0.004] and OS (HR =2.73, 95% CI: 1.76-4.2, P<0.001). Adverse events led to dose reductions in 54.9% of patients, primarily due to general deterioration, hematologic toxicity, or neuropathy. No treatment-related deaths were reported. Conclusions: This real-world study suggests that the paclitaxel-doxorubicin combination provides some clinical activity in previously treated SCLC, including in platinum-resistant/refractory disease. Although toxicities were common, they were generally manageable. These findings support further investigation of this regimen with careful patient selection.
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