Influence of gender on treatment outcome and toxicity in small cell lung cancer (SCLC)

Gender Differences: Implications for Clinical Trials and Practice

“…A retrospective review of outcomes and toxicities of four trials of SCLC was performed by the National Cancer Institute of Canada. 33 At multivariate analysis, women were found to have increased toxicity with chemotherapy, and significantly increased treatment delays (2 or more weeks; p ϭ 0.022) were also observed. Despite the delays, women had an increased overall response rate (80.3% for women vs 66.9% for men; p ϭ 0.0001) and median survival (1.31 years for women and 0.91 for men; p ϭ 0.0001).…”

Tumor-related leucocytosis and chemotherapy-induced neutropenia: Linked or independent prognostic factors for advanced non-small cell lung cancer?

“…More recently, other studies have analyzed the prognostic role of myelotoxicity in patients treated with adjuvant chemotherapy for early breast cancer [38][39][40][41]; in all these studies, the haematological toxicity analyzed (neutropenia [41], myelosuppression [40] or leucocyte nadir [38,39]) showed a significant impact on survival. A retrospective analysis of four clinical trials conducted in patients with SCLC has shown that female patients have a higher incidence of toxicity, with increased response rate and survival, suggesting a gender-related difference in pharmacokinetic or pharmacogenomic profiles [48].…”

“…[37,[49][50][51]. If these assumptions were true, they would suggest that, perhaps, dose should be tailored based on observed toxicity [48,52]. Effective doses are not necessarily higher than those planned with traditional dosing systems; Di Maio et al propose the concept of the "right dose" rather than that of low or high dose; in other words, the principle that efficacy of standard chemotherapy in advanced NSCLC could be improved by looking at neutropenia as a surrogate marker of optimal dosing of drugs [9].…”

Geschlechtsspezifische Unterschiede beim Lungenkarzinom

“…Eine Multivariatanalyse zur Toxizität zeigte für Frauen eine erhöhte Toxizität mit mehr Therapieverschiebungen, aber einem signifikant besseren Ansprechen von 80,3 % bei Frauen gegenüber 66,9 % bei Männern. Auch hatten die Frauen ein signifikant besseres medianes Überleben mit 1,3 Jahren gegenüber 0,91 Jahren bei Männern[98]. Diese Beobachtungen führten dazu, dass in später folgenden SCLC-Studien auch nach Geschlecht stratifiziert wurde.…”