Randomized Phase III Study of Irinotecan Plu Cisplatin Versus Etoposide plus Cisplatin for Completely Resected High-Grade Neuroendocrine Carcinoma of the Lung: JCOG1205/1206

Hirotsugu Kenmotsu, Seiji Niho, Masahiro Tsuboi, Masashi Wakabayashi, Genichiro Ishii, Kazuo Nakagawa, Haruko Daga, Hiroshi Tanaka, Haruhiro Saito, Keiju Aokage, Toshiaki Takahashi, Toshi Menju, Takashi Kasai, Ichiro Yoshino, Koichi Minato, Morihito Okada, Junko Eba, Hisao Asamura, Yuichiro Ohe, Shun Ichi Watanabe

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2 Citations (Scopus)

Abstract

PURPOSE To verify the superiority of irinotecan plus cisplatin over etoposide plus cisplatin as postoperative adjuvant chemotherapy for patients with pathologic stage I-IIIA, completely resected, high-grade neuroendocrine carcinoma (HGNEC) of the lung. METHODS This was a randomized, open-label, phase III study on patients with completely resected stage I-IIIA HGNEC of the lung. They were randomly assigned to receive either etoposide (100 mg/m2, days 1-3) plus cisplatin (80 mg/m2, day 1) or irinotecan (60 mg/m2, days 1, 8, 15) plus cisplatin (60 mg/m2, day 1) up to four cycles. The primary end point was relapse-free survival (RFS) in the intention-to-treat population. This trial was registered with the Japan Registry of Clinical Trials (jRCTs031180216). RESULTS Between April 2013 and October 2018, 221 patients were enrolled (etoposide plus cisplatin arm, 111 patients; irinotecan plus cisplatin arm, 110 patients). In the second interim analysis, early termination of the trial was recommended because of futility. At a median follow-up of 24.1 months, the 3-year RFS was 65.4% for etoposide plus cisplatin and 69.0% for irinotecan plus cisplatin, with a hazard ratio of 1.076 (95% CI, 0.666 to 1.738; one-sided log-rank P 5 .619). Grade 3-4 adverse events were more frequent in the etoposide plus cisplatin arm, with febrile neutropenia (20% of 109 patients v 4% of 107 patients) and neutropenia (97% v 36%) being the most common. Meanwhile, grade 3-4 anorexia (6% v 11%) and diarrhea (1% v 8%) were more frequently observed in the irinotecan plus cisplatin arm. CONCLUSION Irinotecan plus cisplatin is not superior to etoposide plus cisplatin for improving RFS in patients with completely resected HGNEC; thus, etoposide plus cisplatin remains the standard treatment.

Original languageEnglish
Pages (from-to)4292-4301
Number of pages10
JournalJournal of Clinical Oncology
Volume38
Issue number36
DOIs
Publication statusPublished - 2020 Dec 20

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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