Effect of Hospitalization During First Chemotherapy and Performance Status on Small-cell Lung Cancer Outcomes

Rittberg, Rebekah; Green, Sue; Aquin, T.; Bucher, Oliver; Banerji, Shantanu; Dawe, David E.

doi:10.1016/j.cllc.2020.02.013

Cited by 16 publications

(30 citation statements)

References 22 publications

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“…The similar preference between cisplatin and carboplatin is unique, since elsewhere in the world there seems to be a considerably larger preference for carboplatin over cisplatin [8][9][10]. However, the use of carboplatin was higher in this study compared to that in a study conducted on an earlier cohort in Manitoba [6], which could be evidence that the balance between cisplatin and carboplatin may slowly be shifting towards carboplatin in Canada. In contrast, this could also be due to the inclusion of recurrent cases in this study, which were more likely to receive carboplatin plus etoposide.…”

Section: Discussioncontrasting

confidence: 54%

“…The median survival for patients not receiving systemic therapy has been documented to be between 2 to 4 months [2], while patients receiving chemotherapy rarely exceed one year, with median survival across realworld studies from around the world ranging from 7.3 to 16 months [5]. In Canada, it is estimated that the 5-year survival for ES-SCLC patients who receive first-line chemotherapy is 3.7% [6]. There is an unmet need for effective and tolerable treatment options that extend survival for patients with ES-SCLC.…”

Section: Introductionmentioning

confidence: 99%

“…One study described the treatment patterns and survival of 276 ES-SCLC cases treated at a single tertiary cancer centre, but follow-up was limited and therefore long-term outcomes were not described [7]. The two other studies were a study in Manitoba that examined survival of ES-SCLC patients who received first-line chemotherapy [6] and a study conducted in Ontario that examined age-specific treatment patterns but combined LS and ES cases [11]. Since the majority of previous studies on this topic were not truly population based, the results may be subject to selection biases due to the exclusion of patients who were not referred to or treated at a tertiary/academic cancer centre.…”

Section: Introductionmentioning

confidence: 99%

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Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

et al. 2021

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The prognosis for extensive-stage small cell lung cancer (ES-SCLC) is poor. Real-world evidence can highlight the unmet clinical need within this population. We conducted a population-based cohort study of ES-SCLC patients diagnosed in a large Canadian province (2010–2018) using electronic medical records and administrative claims data. In all, 1941 ES-SCLC patients were included, of which 476 (25%) were recurrent cases. Median age at diagnosis was 70 years (range: 39–94) and 50.2% were men. Of the 1941 ES-SCLC patients, 29.5% received chemotherapy and radiotherapy, 17.0% chemotherapy alone, 8.7% radiotherapy alone, and 44.8% received best supportive care. Chemotherapy was initiated by 46.5%, 8.5%, and 1.4% of first-, second-, and third-line patients, with lower uptake for recurrent cases. Median survival from first-, second-, and third-line chemotherapy was 7.82 months (95% CI: 7.50–8.22), 5.72 months (95% CI: 4.90–6.87), and 3.83 months (95% CI: 2.99–4.60). Among patients who received first-line therapy, the 2-year and 5-year survival was 7.3% (95% CI: 5.7–9.2) and 2.9% (95% CI: 1.8–4.5). In conclusion, initiation of first-line treatment in ES-SCLC was low with significant attrition in subsequent lines. These results underscore the need for effective front-line treatments and highlight the potential for novel therapies to improve patient outcomes.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

et al. 2021

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“…Poor PS patients are not able to carry any work activity, still ambulatory, fully capable of selfcare and up more than 50% of waking hours (ECOG PS 2), or only partially autonomous in selfcare and confined to bed or chair more than 50% of waking hours (ECOG PS 3), while ECOG PS 4 patients are completely disabled. PS, representing an estimation of patients' global fitness, figure among the most solid prognostic factors in lung cancer (9)(10)(11)(12), as well as across other disease types and stages. As an alternative to ECOG measure, Karnofsky score (ranging from 100-best-to 0-worst-) is used to assess patients' fitness as well (8,13).…”

Section: Introductionmentioning

confidence: 99%

First-line immunotherapy in non-small cell lung cancer patients with poor performance status: a systematic review and meta-analysis

Facchinetti¹,

Maïo²,

Perrone³

et al. 2021

Transl Lung Cancer Res

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Background: Immune checkpoint inhibitors (ICIs) have become the standard of care for the first-line treatment of advanced non-small cell lung cancer patients (NSCLC), either as single agents or combined with chemotherapy. The evidence sustaining their role for poor performance status (ECOG PS ≥2) patients is limited. Methods:We search PubMed and the proceedings of international oncology meetings to perform a systematic review to assess the outcomes poor PS NSCLC patients who received ICIs as first-line treatment.A meta-analysis included retrospective studies focusing on pembrolizumab monotherapy in PD-L1 ≥50% NSCLC. We reported the global objective response rate (ORR), disease control rate (DCR) and landmark progression-free and overall survival (PFS and OS, respectively) in ECOG PS ≥2 and 0-1 patients, respectively.Results: Forty-one studies were included in the systematic review. Thirty-two retrospective studies focused on pembrolizumab monotherapy in PD-L1 ≥50% cases. 1030 out of 5357 (19%) of patients across 30 studies presented with a PS ≥2 at pembrolizumab initiation. In 18 studies with detailed clinical information, worse outcomes in poor PS compared to good PS patients were documented. The meta-analysis revealed that ORR and DCR within the PS ≥2 patient population were 30.9% and 41.5% respectively (55.2% and 71.5% in PS 0-1 patients). The rates of PFS (at three, six, 12 and 18 months) and OS (at six, 12, 18 and 24 months) were approximately double in the good PS compared to the poor PS group of patients. In the three prospective trials where of ICIs in PS 2 populations, the diverse strictness in PS definition likely contributed to the differential outcomes observed. Six retrospective studies dealt with chemo-immunotherapy combinations.Conclusions: Still with limited prospective evidence sustaining the role of immunotherapy in previously untreated NSCLC with poor PS, 19% of patients in retrospective series dealing with pembrolizumab in PD-L1 ≥50% tumors had an ECOG PS ≥2. Clinical effort encompassing the definition of poor PS, of the factors conditioning it, and the development of dedicated treatment strategies is required to improve the outcomes in this patient population.

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“…For other patients, treatment options are limited to the application of platinum-based cytotoxic chemotherapy, whose response rates range from 15% to 30% [ 4 ]. Patients with small-cell lung cancer, which accounts for 10-15% of the primary pulmonary malignancies, are almost exclusively smokers, and this disease is characterized by rapid doubling time, high response to first-line chemotherapy and a high relapse rate [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Psychological Distress of Lung Cancer Patients Undergoing Chemotherapy

Prapa¹,

Papathanasiou

Bakalis

et al. 2021

World J Oncol

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Background: Patients with lung cancer often experience multiple symptoms associated with both the disease itself and the treatment. The disease and therapy-related adverse effects may lead to poor quality of life (QoL) and increased psychological distress. The aim of this study was to investigate the QoL and psychological distress of patients with lung cancer. The relationship between these two aspects was also an area of focus.Methods: This was a quantitative descriptive study. Data collection was done using a self-complementary tool. The data were collected between February and March 2020. The sample consisted of 135 patients with lung cancer who were undergoing chemotherapy in 1-day clinic in Athens (a sample of convenience). Results:Regarding the QoL of our sample, we observed that the mean score of the physical health component of SF-12 was 38.17 ± 9.94 and of the mental health component was 45.63 ± 11.80. As regards the psychological distress of our sample, we observed that the mean score for depression was 4.55 ± 5.04, for anxiety was 3.84 ± 4.17 and for stress was 5.21 ± 5.01. Conclusion:As is clear from the results, lung cancer patients reported poor QoL and increased rates of psychological distress.

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Effect of Hospitalization During First Chemotherapy and Performance Status on Small-cell Lung Cancer Outcomes

Cited by 16 publications

References 22 publications

Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

First-line immunotherapy in non-small cell lung cancer patients with poor performance status: a systematic review and meta-analysis

Quality of Life and Psychological Distress of Lung Cancer Patients Undergoing Chemotherapy

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