Comparison of second-line treatment outcomes between sensitive and refractory small cell lung cancer patients: a retrospective analysis

Korkmaz, Taner; Seber, S.; Kefeli, Umut; Sarı, Ebru Karadağ; Canhoroz, Mustafa; Öven, Bala Başak; Yıldırım, Emre; Yaşar, Nurgül; Aydın, Davut; Balvan, Ozlem; Sener, Nur; Yuksel, Sinemis; Mert, Aslıhan Güven; Polat, O.; Yumuk, Perran Fulden; Kanat, Özkan; Gümüş, Mahmut; Turhal, Nazım Serdar

doi:10.1007/s12094-012-0960-6

Cited by 16 publications

(13 citation statements)

References 20 publications

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“…These results are divergent from prior studies in this context [12] and particularly, from the recent results of a randomized study comparing amrubicin with topotecan in which 637 relapsed SCLC patients were randomized 2:1 to either amrubicin or topotecan [13]. The top-line results of that trial showed that despite a higher response rate in the amrubicin arm (31 vs 17%, p=0.0002), there was no apparent difference in overall survival (HR 0.88, p=0.17).…”

Section: Discussioncontrasting

confidence: 99%

Relevance of Platinum-Sensitivity Status in Relapsed/Refractory Extensive-Stage Small-Cell Lung Cancer in the Modern Era: A Patient-Level Analysis of Southwest Oncology Group Trials

Lara

Moon

Redman

et al. 2015

Journal of Thoracic Oncology

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Background Extensive stage small cell lung cancer (ES-SCLC) patients who progress following platinum-based chemotherapy are traditionally categorized as platinum-sensitive (progression ≥ 90 days from last platinum dose) or refractory (progression< 90 days), apractice arising from seminal observations of worse survival in refractory patients. Subsequent trials accounted for platinum-sensitivity, resulting in higher sample sizes and increased resource use. Methods To assess whether platinum-sensitivity status remains associated with outcomes, patient-level data from recent SWOG trials in 2nd and/or 3rd line ES-SCLC were pooled. Hazard ratios (HRs) for progression-free (PFS) and overall survival (OS) accounting for platinum sensitivity were calculated using unadjusted and adjusted Cox Proportional Hazard models. Recursive partitioning was performed to define prognostic risk groups. Results Of 329 patients, 151 were platinum-sensitive, 178 refractory. Hazard ratios from unadjusted Cox PFS and OS models for refractory vs. sensitive disease were 1.0 (95% CI 0.81–1.25, p=0.98) and 1.24 (0.99, 1.57; p=0.06), respectively. Adjusted Cox models showed that only elevated serum LDH (HR 2.04, p<0.001), males (HR 1.36, p=0.04), performance status of 1 (HR 1.25, p=0.02), and weight loss ≥ 5% (1.53, p=0.01) were independently associated with OS. Platinum sensitivity status was not associated with PFS (HR 1.11, p=0.49) or OS (HR 1.25, p=0.14), except in a model that excluded 36 patients who received > 1 prior chemotherapy regimen (HR=1.34, p=0.049). Prognostic groups with differential OS outcomes (high, intermediate, and poor risk) were identified. Conclusions Platinum sensitivity status may no longer be strongly associated with PFS or OS in at least one multivariate model. Validation of prognostic risk groups identified here is warranted. These data have critical implications in the design of future SCLC trials.

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Section: Discussioncontrasting

confidence: 99%

Relevance of Platinum-Sensitivity Status in Relapsed/Refractory Extensive-Stage Small-Cell Lung Cancer in the Modern Era: A Patient-Level Analysis of Southwest Oncology Group Trials

Lara

Moon

Redman

et al. 2015

Journal of Thoracic Oncology

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“…One is second-line therapy for small-cell lung cancer, where reports (although retrospective) have found significantly higher rr, progression-free survival, and os on re-challenge in platinum-sensitive patients [16][17][18][19][20] .…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy

et al. 2016

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“…Platinum rechallenge means platinum‐based second‐line chemotherapy in patients pretreated with platinum‐based chemotherapy. In SCLC, the platinum‐sensitive group includes patients who have a time‐to‐progression (TTP) of at least 3 months, and platinum rechallenge second‐line chemotherapy results in better progression‐free survival (PFS) and OS . In ovarian cancer, disease that recurs more than 6 months after prior therapy is categorized as “platinum sensitive,” and platinum‐based therapy is the principal regimen for it in second‐line treatment .…”

Section: Introductionmentioning

confidence: 99%

A prognostic model for platinum‐doublet as second‐line chemotherapy in advanced non‐small‐cell lung cancer patients

Hao

Liu

et al. 2016

Cancer Medicine

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Poor prognosis of advanced non‐small‐cell lung cancer (NSCLC) patients and the promising therapeutic effect of platinum urge the oncologists to evaluate the role of platinum doublet as second‐line chemotherapy and establish the definition of platinum sensitivity in NSCLC. We retrospectively analyzed 364 advanced NSCLC patients who received platinum‐doublet regimens as second‐line chemotherapy after platinum‐based first‐line treatment. Patients were divided into four groups by their time‐to‐progression (TTP) after first‐line chemotherapy: 0–3, 4–6, 7–12, and >12‐month group, respectively. Treatment efficacy of patients' overall survival (OS), progression‐free survival (PFS), and response rate (RR), as well as treatment‐related toxicity, were compared among the four groups. A prognosis score system and a nomogram were established by Cox proportional hazard model, and validated by concordance index (c‐index). Median OS was 14.0, 16.0, 20.0, 25.0 months for patients in the 0–3, 4–6, 7–12, >12‐month group, respectively. Age ≤60 years (P = 0.002), female (P = 0.019), and TTP>12 months (P = 0.003) were independent prognostic factors. Prognostic score was calculated by adding 1 point each for any of the above three indicators, with a c‐index of 0.590 (95% confidential interval [CI], 0.552–0.627). Median OS were equal to 25.0, 16.0, and 11.0 months for best (2–3 points), intermediate (1 point) and worst (0 point) category, respectively (P < 0.0001). A nomogram that integrated patient's age, gender, and TTP for OS has a c‐index of 0.623 (95% CI, 0.603–0.643). Female, younger than 60 years, and TTP greater than 12 months may indicate prolonged survival after platinum‐doublet second‐line chemotherapy in advanced NSCLCpatients.

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Comparison of second-line treatment outcomes between sensitive and refractory small cell lung cancer patients: a retrospective analysis

Abstract: Patients with good ECOG PS,who have PSD or initially presenting with LS, have a good prognosis and in patients with PSD, platinum-based therapy would be more appropriate.

Cited by 16 publications

References 20 publications

Relevance of Platinum-Sensitivity Status in Relapsed/Refractory Extensive-Stage Small-Cell Lung Cancer in the Modern Era: A Patient-Level Analysis of Southwest Oncology Group Trials

Relevance of Platinum-Sensitivity Status in Relapsed/Refractory Extensive-Stage Small-Cell Lung Cancer in the Modern Era: A Patient-Level Analysis of Southwest Oncology Group Trials

Chemotherapy in Recurrent Advanced Non-Small-Cell Lung Cancer After Adjuvant Chemotherapy

A prognostic model for platinum‐doublet as second‐line chemotherapy in advanced non‐small‐cell lung cancer patients

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