Efficacy and safety of amrubicin therapy after chemoimmunotherapy in small cell lung cancer patients

BACKGROUND: Although the addition of immune checkpoint inhibitors (ICIs) to platinum-doublet chemotherapy has improved the efficacy of first-line therapy in extensive-disease small cell lung cancer (SCLC) patients, the best treatment option for patients with recurrent SCLC has not yet been determined. We conducted a retrospective study to evaluate the efficacy and safety of amrubicin (AMR) therapy after treatment with ICIs. METHODS: We retrospectively assessed patients with recurrent SCLC who received AMR after chemoimmunotherapy at the Niigata Lung Cancer Treatment Group from August 2019 to February 2021. RESULTS: This analysis included 30 patients. The median progression-free survival (PFS) and overall survival (OS) were 3.8 (95% CI: 2.7–4.2) and 10 (95% CI: 7.4–14.8) months, respectively. The median PFS and OS did not significantly differ between the sensitive and refractory groups [PFS; 3.1 (95% CI: 1.1–4.0) vs. 4.2 (95% CI: 2.3–4.8) months, P=0.1142, OS; 10.0 (95% CI: 5.2–14.8) vs. 10.4 (95% CI: 3.8–NE) months, P=0.5525]. The most common adverse event was grade ≥3 neutropenia, which occurred in 22 of 30 patients (73%), and 2 patients (7%) discontinued AMR due to adverse events. CONCLUSIONS: AMR after chemoimmunotherapy shows good clinical efficacy and safety in patients with recurrent SCLC.