Response to chemotherapy has predictive value for further survival of patients with advanced non-small cell lung cancer: 10 years experience of the european lung cancer working party

Paesmans, Marianne; Sculier, Jean-Paul; Libert, P; Bureau, G.; Dabouis, G; Thiriaux, J; Michel, Jeffrey; Cutsem, O Van; Sergysels, Roger; Mommen, Paul; Klastersky, Jean

doi:10.1016/s0959-8049(97)00325-0

Cited by 80 publications

(46 citation statements)

References 19 publications

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“…This is consistent with previous studies, which have shown that a raised white cell count (Paesmans et al, 1997) CRP ¼ C-reactive protein; median survival (95% CI).…”

Section: Discussionsupporting

confidence: 93%

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Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer

et al. 2003

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“…This is consistent with previous studies, which have shown that a raised white cell count (Paesmans et al, 1997) CRP ¼ C-reactive protein; median survival (95% CI).…”

Section: Discussionsupporting

confidence: 93%

“…Grouping of the variables age, tumour type, performance status (ECOG), haemoglobin, white cell count and albumin was carried out using standard thresholds (Paesmans et al, 1997;Herndon et al, 1999). C-reactive protein concentrations were also grouped (p10/410 mg l Àl ) as previously described (O'Gorman et al, 2000).…”

Section: Statisticsmentioning

confidence: 99%

Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer

et al. 2003

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“…In contrast, the GPS, based as it is on the presence of an ongoing systemic inflammatory response and hypoalbuminaemia, predicts the progressive nutritional decline of the patient (McMillan et al, 2001;Scott et al, 2002). Indeed, it has long been recognised that progressive weight loss is associated with poor tolerance to chemotherapy (Chlebowski et al, 1996;Paesmans et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer

et al. 2004

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The value of an inflammation-based prognostic score (GPS) was compared with performance status (ECOG) in patients (n ¼ 109) receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. On multivariate analysis with ECOG, white cell count and the GPS entered as covariates, only the GPS was a significant independent predictor of survival (HR 1.88, 95% CI 1.25 -2.84, P ¼ 0.002). Non-small-cell lung cancer (NSCLC) is the most common cause of cancer death in North America and Western Europe. Most patients present with advanced inoperable disease; the prognosis of these patients is extremely poor. In selected patients, platinum-based regimens have been shown to have a beneficial but modest impact on survival (Klastersky and Paesmans, 2001). Conventionally, the selection of patients for chemotherapy has been based on clinicopathological criteria, including age, stage and performance status (Numico et al, 2001).There is increasing evidence that the presence of a systemic inflammatory response, as evidenced by elevated circulating concentrations of C-reactive protein concentrations, is associated with early recurrence and poor survival, independent of stage, in a variety of common solid tumours (Ikeda et al, 2003;McMillan et al, 2003). In advanced disease, an elevated C-reactive protein has also been shown to associated with poor survival (O'Gorman et al, 2000;Mahmoud and Rivera, 2002).Furthermore, in an unselected cohort of patients with inoperable NSCLC, the Glasgow Prognostic Score (GPS), a cumulative prognostic score based on C-reactive protein and albumin, had similar prognostic value to that of stage and performance status (Forrest et al, 2003). The question of whether the GPS would be useful in the selection of appropriate treatment for patients with inoperable NSCLC remains to be determined.The aim of the present study was to assess the value of the GPS in patients receiving chemotherapy for inoperable NSCLC. MATERIALS AND METHODS Study designPatients presenting with inoperable NSCLC (stages III and IV) to a single multidisciplinary oncology clinic in Glasgow Royal Infirmary between March 2000 and June 2003 were studied prospectively. All patients had cytologically or histologically confirmed disease and were staged on the basis of clinical findings, chest X-ray and, where appropriate, bronchoscopy, liver ultrasound, isotope bone scan and computerised tomography of the thorax, according to the American Thoracic Society TNM classification (Mountain, 1991).Clinical stage, tumour type and performance status (Eastern Cooperative Oncology Group, ECOG) were recorded at the time of diagnosis. A blood sample was also obtained for the measurement of white cell count, albumin and C-reactive protein concentrations. Patients received between one and six cycles of platinum-based chemotherapy.The study was approved by the Research Ethics Committee of Glasgow Royal Infirmary. MethodsBlood parameters: Routine laboratory measurements of albumin and C-reactive protein concentration were carried out. The coeffic...

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“…The awareness of prognostic determinants of NSCLC may be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). For clinical trials, stratification of randomisation on known prognostic factors is an important part of procedure.…”

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confidence: 99%

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

et al. 2005

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Treatment of non-small-cell lung cancer (NSCLC) might take into account comorbidities as an important variable. The aim of this study was to generate a new simplified comorbidity score (SCS) and to determine whether or not it improves the possibility of predicting prognosis of NSCLC patients. A two-step methodology was used.Step 1: An SCS was developed and its prognostic value was compared with classical prognostic determinants in the outcome of 735 previously untreated NSCLC patients.Step 2: the SCS reliability as a prognostic determinant was tested in a different population of 136 prospectively accrued NSCLC patients with a formal comparison between SCS and the classical Charlson comorbidity index (CCI). Prognosis was analysed using both univariate and multivariate (Cox model) statistics. The SCS summarised the following variables: tobacco consumption, diabetes mellitus and renal insufficiency (respective weightings 7, 5 and 4), respiratory, neoplastic and cardiovascular comorbidities and alcoholism (weighting ¼ 1 for each item). In step 1, aside from classical variables such as age, stage of the disease and performance status, SCS was a statistically significant prognostic variable in univariate analyses. In the Cox model weight loss, stage grouping, performance status and SCS were independent determinants of a poor outcome. There was a trend towards statistical significance for age (P ¼ 0.08) and leucocytes count (P ¼ 0.06). In Step 2, both SCS and well-known prognostic variables were found as significant determinants in univariate analyses. There was a trend towards a negative prognostic effect for CCI. In multivariate analysis, stage grouping, performance status, histology, leucocytes, lymphocytes, lactate dehydrogenase, CYFRA 21-1 and SCS were independent determinants of a poor prognosis. CCI was removed from the Cox model. In conclusion, the SCS, constructed as an independent prognostic factor in a large NSCLC patient population, is validated in another prospective population and appears more informative than the CCI in predicting NSCLC patient outcome.

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Response to chemotherapy has predictive value for further survival of patients with advanced non-small cell lung cancer: 10 years experience of the european lung cancer working party

Cited by 80 publications

References 19 publications

Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer

Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer

Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer

A new simplified comorbidity score as a prognostic factor in non-small-cell lung cancer patients: description and comparison with the Charlson's index

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