DISCUSSION
NSCLC, neutropenia, diarrhea, leukopenia, toxicity, toxicities, cancer, anemia
NEUTROPENIA, LEUKOPENIA, ADVERSE EVENTS, CANCER, SQUAMOUS CELL LUNG CANCER, ANEMIA, NSCLC, RECURRENT NSCLC
In this study, we evaluated the efficacy and safety of CPT‐11 and S‐1 combination in patients with previously treated advanced or recurrent squamous cell lung cancer. We obtained an ORR of 6.7%, whereas the median PFS and OS were 3.0 months and 10.5 months, respectively. To the best of our knowledge, only two studies have evaluated the efficacy and safety of CPT‐11 and S‐1 combination in patients with previously treated advanced or recurrent NSCLC. Goya et al.Although we had planned that CPT‐11 would be administered at a dose of 70 mg/mThe toxicity profiles of adverse events were as expected. For instance, 6/29 patients (20.7%) experienced grade 3/4 leukopenia or neutropenia, which was consistent with the results of previous studies on second‐line treatment. In these studies, the incidence of grade 3/4 neutropenia in patients treated with combined CPT‐11 and S‐1 was 9.7%–17.9%. With respect to nonhematological toxicities, grade 3/4 diarrhea occurred in 2/29 patients (6.9%), which was within the acceptable range. Of note, 5/29 patients (17.2%) experienced grade 3/4 anemia. Although no patients developed grade 4 anemia, we should keep in mind that anemia can sometimes be life‐threatening.This study had several limitations. First, immunotherapy was introduced into clinical practice after this trial, and no patients were initially treated with immunotherapy. Immune checkpoint inhibitor (ICI) monotherapy, ICIs plus chemotherapy, and ICI combination therapy are currently the standard treatments for advanced NSCLC. Therefore, our study does not reflect recent advances in immunotherapy. Interestingly, the combination of S‐1 and/or CPT‐11 with immunotherapy may be a candidate regimen for other cancer because the synergy effects of these drugs have been reported.In conclusion, CPT‐11 and S‐1 combination was not superior to single‐agent therapy in terms of ORR, although the toxicity profile was as expected. This combination did not yield the expected effect and may not be a candidate regimen for future phase III trials.