Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Clinical Efficacy of Belotecan (CKD-602), Newly Developed Camptothecin Analog, in the 2nd Line Treatment of Relapsed Small Cell Lung Cancer

재발된 소세포폐암환자에서 이차 약제로 사용되는 Belotecan (CKD-602)의 임상적 효용성

  • Ban, Hee-Jung (Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Oh, In-Jae (Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital) ;
  • Kim, Kyu-Sik (Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital) ;
  • Ju, Jin-Yung (Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kwon, Yong-Soo (Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Yu-Il (Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Lim, Sung-Chul (Department of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Young-Chul (Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital)
  • 반희정 (전남대학교 의과대학 호흡기내과학교실) ;
  • 오인재 (화순전남대학교병원 폐식도 클리닉) ;
  • 김규식 (화순전남대학교병원 폐식도 클리닉) ;
  • 주진영 (전남대학교 의과대학 호흡기내과학교실) ;
  • 권용수 (전남대학교 의과대학 호흡기내과학교실) ;
  • 김유일 (전남대학교 의과대학 호흡기내과학교실) ;
  • 임성철 (전남대학교 의과대학 호흡기내과학교실) ;
  • 김영철 (화순전남대학교병원 폐식도 클리닉)
  • Received : 2008.12.05
  • Accepted : 2009.02.03
  • Published : 2009.02.28
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Abstract

Background: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea), a camptothecin derivative, has anticancer effects by inhibiting topoisomerase I such as topotecan. This study observed the response, survival and toxicity of belotecan monotherapy after the failure of etoposide and platinum (EP). Methods: Forty nine small cell lung cancer (SCLC) patients (M/F=41/8; age, 64.5${\pm}$7.6 (mean${\pm}$SD) years), who failed in their first line chemotherapy were enrolled in this study. Twenty one SCLC patients showed relapsed lung cancer more than 90 days after their priorEP chemotherapy (sensitive relapse group, SR) and 28 patients relapsed within 90 days (refractory relapse group, RR). Results: The response rate was 25%. Eleven patients showed partial responses and 5 patients could not be checked. The response rate of the SR and RR patients was similar. The relative dose intensity was lower in the responders (78${\pm}$15%) than non-responders (83${\pm}$13%, p=0.03). The median survival time (MST) was 10.3 months (290 days). The MST of the non-responders and responders was 186 days (95% CI; 67-305) and 401 days (95% CI; 234-568, p=0.07), respectively. The median progression free survival (MPFS) was similar in the SR (79 days) and RR (67 days) patients. Grade 3-4 neutropenia, anemia, and thrombocytopenia were observed in 59.6%, 12.8% and 23.4% of patients, respectively. Conclusion: The efficacy and survival were demonstrated in the second-line setting. However, a randomized comparative trial with topotecan will be needed.

연구배경: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea)은 camptothecin의 치환체로 topoisomerase I 효소를 억제하여 항암효과를 나타내는 것으로 알려져 있다. 이에 2차 항암화학요법에 치료제로써 Belotecan 의 효과, 생존율 및 부작용에 대해 연구하였다. 방 법: 이에 소세포폐암에서 etoposide와 platinum을 사용한 1차 항암화학요법에서 실패한 49명의 환자들을 대상으로 2차 항암화학요법에 Belotecan을 투약하였다. 결 과: 전체 반응률은 25%였으며, 11명의 환자에서 partial response를 보였다. 또한 1차 항암화학요법 이후 90일 이내에 재발한 군과 90일 이상 경과한 군간에 유의한 차이는 보이지 않았다. 전체 환자의 중심생존기간은 10.3개월(290일)이었고, 비반응군에서는 186일(95% CI; 67-305)로 반응군의 471일(95% CI; 234-568)에 비해 생존기간의 감소 유의하게 있음을 확인하였다(p=0.07). 결 론: 2차 항암화학요법의 치료제로써 Belotecan의 효능과 부작용에 대해서는 향후 무작위 비교 연구가 필요할 것으로 사료된다.

Keywords

References

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