Chimiothérapie : Libre accès
Libre accès

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Amrubicin Monotherapy for Patients with Small-Cell Lung Carcinoma Complicated with Chronic Renal and Chronic Heart Failure

Nobuhiro Takeuchi, Yusuke Nomura, Masato Iida, Kento Yamamoto, Masanori Takada, Tetsuo Maeda, Akihito Otsuka, Hidetoshi Tada, Tadashi Nakamura, Kikuo Ichihara and Kazuyoshi Naba

An 82-year-old female presented to our institution with mild dyspnea. Her medical history included effort angina pectoris, which was treated with stent placement in the coronary artery at the age of 78, and congestive heart failure, which was improved by oxygen inhalation and administration of diuretic agents. Chest radiography revealed evidence of swollen lymph nodes at the level of the left pulmonary hilar lesion. Contrast-enhanced chest computed tomography revealed a mass at the pulmonary hilar lesion site extending into the left pulmonary artery and left lower pulmonary vein, swollen lymph nodes proximal to the left pulmonary hilar lesion and bilateral mediastinum, and pleural dissemination. Bronchoscopy revealed almost total occlusion of the left upper bronchial trunk. Biopsied specimen confirmed the diagnosis of small-cell lung carcinoma (SCLC). Although the standard chemotherapy regimen for extended SCLC is a combination therapy of cisplatin (CDDP) and etoposide (ETP), that regimen was considered intolerable for the patient because of chronic heart and renal failure. Therefore, the regimen of amrubicin hydrochloride (AMR) monotherapy was decided. After the first cycle of chemotherapy, the tumor was remarkably reduced. Despite mild digestive symptoms, including nausea and loss of appetite, and mild myelosuppression, the patient was well tolerated with AMR monotherapy. The patient has been kept partial response during the fifth cycle of chemotherapy until the patient developed pneumonia.