Table 5.

Study 478: Potential reasons for not being suitable for repeat first line treatment

Reasons	Relevance to study 478 population
Short time to progression	54% of patients in the trial had a treatment free interval (TFI) of ≤90 days
Residual toxicity to first line regimen	13% of patients in the best supportive care + topotecan arm and 10% in the best supportive care arm had residual toxicity
Patient preference not to receive further intravenous chemotherapy	O'Brien et al report that some patients in the study with sensitive SCLC refuse further intravenous chemotherapy because of the risk of toxicity or become unsuitable for standard chemotherapy because of co-morbidities