Dalotuzumab in extensive-stage small-cell lung cancer

The authors aimed to determine the effects of dalotuzumab in treating small-cell lung cancer when combined with cisplatin and etoposide.

Extensive-stage small-cell lung cancer (SCLC – cancer has spread outside of the chest) represents 15% of all lung cancer cases. Though numerous treatments have been used over the past 15 years to treat SCLC, none of these have shown great improvements in patient survival. This may be due to the fact that a number of abnormalities have been found in SCLC tumors, making treatment difficult.

Cisplatin (Cisplatinum, Platamin, Neoplatin, Cismaplat) and etoposide (Toposar, Etopophos) are an example of chemotherapy drugs currently used in treating lung cancer. Emerging drugs in SCLC, such as dalotuzumab (MK-0646), target the pathway involved in cell and tissue growth.

The authors aimed to study the effect of dalotuzumab in treating SCLC when combined with cisplatin and etoposide.

12 patients were used in this study. Patients were given dalotuzumab in combination with chemotherapy drugs cisplatin and etoposide. The response rate to treatment was 67%, where 8 patients experienced a partial response (cancer responded to treatment but was not eradicated fully) to treatment, 2 patients had stable disease (cancer did not progress after treatment but remained the same) and 1 patient experienced cancer progression after treatment.

92% of patients experienced low immune cell count (cells that fight infection) while 25% experienced low platelet count (cells involved in blood clotting). 33% of patients experienced fatigue, 17% experienced joint pain and 25% experienced blood clots. Patients also experienced high blood sugar levels which increased when the drug dose was increased.

3 patients experienced serious side-effects during treatment where 1 patient died due to a low immune cell count, 1 patient experienced a blood clot in their lung and a fever and 1 patient experienced multiple side effects including chest discomfort, fatigue, stomach pain, joint pain and shortness of breath when treated with dalotuzumab alone.

The authors conclude that dalotuzumab can be safely administered with cisplatin and etoposide with side-effects experienced as expected.

Results from this study cannot be widely applied due to the small number of patients used and the novelty of the experiment.

If you are considering chemotherapy as a treatment option for small-cell lung cancer please consult your doctor.