Koichi Saruwatari1, Shigeki Umemura2, Shogo Nomura3, Keisuke Kirita1, Shingo Matsumoto1, Kiyotaka Yoh1, Seiji Niho1, Hironobu Ohmatsu1, Yuichiro Ohe4, Koichi Goto1. 1. Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. 2. Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. Electronic address: sumemura@east.ncc.go.jp. 3. Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Kashiwa, Japan. 4. Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Abstract
BACKGROUND: There is little information on the clinical outcome of patients with small-cell lung cancer (SCLC) treated with third-line chemotherapy. The purpose of this study was to clarify the prognostic factors of SCLC patients receiving third-line chemotherapy. PATIENTS AND METHODS: Between November 2001 and October 2011, 202 of 648 consecutive SCLC patients at the National Cancer Center Hospital East received third-line chemotherapy. Multivariate Cox regression analysis was performed to identify the prognostic factors for overall survival after third-line chemotherapy. RESULTS: The demographics of the 202 patients were as follows: median age 66 years, 83% male, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2, and 3 values of 22, 122, 49, and 9, respectively. Median time to treatment failure after second-line chemotherapy (TTF2) was 4.5 months (TTF2 ≥ 5/< 5 months, 82/120). The median overall survival after third-line chemotherapy was 5.1 months. Multivariate Cox regression analysis showed that PS 0-1 (hazard ratio, 0.38; 95% confidence interval, 0.27-0.54; P < .001) and TTF2 ≥ 5 months (hazard ratio, 0.57; 95% confidence interval, 0.41-0.79; P < .001) were independent prognostic factors. TTF2 threshold of 5 months was determined on the basis of concordance probability adjusted by PS. CONCLUSION: PS 0-1 and TTF2 ≥ 5 months were associated with a favorable prognosis among SCLC patients receiving third-line chemotherapy. These 2 factors might be helpful for the selection of candidates for third-line chemotherapy and for patient stratification when conducting future clinical trials in the third-line setting.
BACKGROUND: There is little information on the clinical outcome of patients with small-cell lung cancer (SCLC) treated with third-line chemotherapy. The purpose of this study was to clarify the prognostic factors of SCLCpatients receiving third-line chemotherapy. PATIENTS AND METHODS: Between November 2001 and October 2011, 202 of 648 consecutive SCLCpatients at the National Cancer Center Hospital East received third-line chemotherapy. Multivariate Cox regression analysis was performed to identify the prognostic factors for overall survival after third-line chemotherapy. RESULTS: The demographics of the 202 patients were as follows: median age 66 years, 83% male, and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, 2, and 3 values of 22, 122, 49, and 9, respectively. Median time to treatment failure after second-line chemotherapy (TTF2) was 4.5 months (TTF2 ≥ 5/< 5 months, 82/120). The median overall survival after third-line chemotherapy was 5.1 months. Multivariate Cox regression analysis showed that PS 0-1 (hazard ratio, 0.38; 95% confidence interval, 0.27-0.54; P < .001) and TTF2 ≥ 5 months (hazard ratio, 0.57; 95% confidence interval, 0.41-0.79; P < .001) were independent prognostic factors. TTF2 threshold of 5 months was determined on the basis of concordance probability adjusted by PS. CONCLUSION: PS 0-1 and TTF2 ≥ 5 months were associated with a favorable prognosis among SCLCpatients receiving third-line chemotherapy. These 2 factors might be helpful for the selection of candidates for third-line chemotherapy and for patient stratification when conducting future clinical trials in the third-line setting.
Authors: Damian von Eiff; Farastuk Bozorgmehr; Inn Chung; Denise Bernhardt; Stefan Rieken; Stephan Liersch; Thomas Muley; Sonja Kobinger; Michael Thomas; Petros Christopoulos; Martin Steins Journal: J Thorac Dis Date: 2020-03 Impact factor: 2.895