Carboplatin in combination with etoposide for advanced small cell lung cancer complicated with idiopathic interstitial pneumonia: a single-arm phase II study

BMC Pulm Med. 2025 Jan 8;25(1):9. doi: 10.1186/s12890-024-03459-y.

Abstract

Background: Acute exacerbation (AEx) of interstitial pneumonia is the most common lethal adverse event related to the pharmacological treatment of patients with lung cancer complicated with interstitial pneumonia. Although small cell lung cancer (SCLC) is linked to poor prognosis, it exhibits good response to chemotherapy. Few previous research studies have investigated the safety and efficacy of treatment for advanced SCLC complicated with idiopathic interstitial pneumonia (IIP). We conducted a single-arm phase II study to evaluate the safety and efficacy of carboplatin plus etoposide for the treatment of patients with SCLC complicated with IIP.

Methods: Chemotherapy-naïve patients with advanced SCLC complicated with IIP were enrolled. Patients received carboplatin every 21-28 days at a dose of area under the curve 4-6 on day 1 and etoposide at a dose of 80-100 mg/m2 on days 1-3.

Results: Thirty-one patients were enrolled between December 2009 and December 2022. A median of four cycles of carboplatin plus etoposide were administered. Acute exacerbation of idiopathic interstitial pneumonia was not observed; the rate of AEx was 0% (95% confidence interval [CI]: 0-9.6%, p = 0.038). The objective response rate was 83.9% (95% CI: 82.5-85.2). The median progression-free survival and overall survival were 5.9 (95% CI: 4.7-6.8) months and 14.0 (95% CI: 7.6-27.6) months, respectively. The 1-year survival rate was 61% (95% CI 41-76).

Conclusions: The carboplatin plus etoposide treatment was tolerable and effective in SCLC patients complicated with IIP.

Keywords: Acute exacerbation; Chemotherapy; Idiopathic interstitial pneumonia; Idiopathic pulmonary fibrosis; Small cell lung cancer.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols* / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Carboplatin* / administration & dosage
  • Etoposide* / administration & dosage
  • Etoposide* / adverse effects
  • Female
  • Humans
  • Idiopathic Interstitial Pneumonias* / complications
  • Idiopathic Interstitial Pneumonias* / drug therapy
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / pathology
  • Male
  • Middle Aged
  • Progression-Free Survival
  • Small Cell Lung Carcinoma* / complications
  • Small Cell Lung Carcinoma* / drug therapy
  • Treatment Outcome

Substances

  • Etoposide
  • Carboplatin