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  P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

  • 26575

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    P1.12-09 - The Effect of Site of First Chemotherapy on Small Cell Lung Cancer Patient Outcomes (ID 13082)

    16:45 - 18:00  |  Author(s): Rebekah Rittberg
    • Abstract
    • Slides

    Background
    

    Small cell lung cancer (SCLC) ischaracterized by a rapid doubling time and high responsiveness to chemotherapy (CT) with a rapid relapse. Due to the sensitivity of SCLC to CT, it is one of the few malignancies treated in acutely ill patients admitted to hospital with a poor performance status (PS). However, there is little available information on the outcomes and toxicity experienced by patients with SCLC who require initial CT as an inpatient.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    A retrospective cohort study was conducted evaluating patients consecutively diagnosed with SCLC in Manitoba from 2004 to 2013 treated with platinum-doublet CT. Patient demographics, staging, treatment, CT toxicities, Eastern Cooperative Oncology Group(ECOG) PS, treatment response, and survival were collected using the Manitoba Cancer Registry and chart review. Outcomes of progression free survival (PFS) and overall survival (OS) were evaluated based on site of first CT (inpatient versus outpatient) and PS.

    4c3880bb027f159e801041b1021e88e8 Result
    

    530 patients received CT for SCLC with 82 patients (15%) receiving their first CT as an inpatient. Sixty-three percent of inpatients received the full CT course, compared to 81% of outpatients, (p=0.0006). Outpatients had a greater likelihood of responding to CT (p=0.0043). Neutropenia, febrile neutropenia, thrombocytopenia, nephrotoxicity and fatigue were all experienced less often by the inpatient cohort, (p<0.0001), (p=0.0040), (p<0.0001), (p<0.0001) and (0.0068). For inpatients, OS at 12, 24 and 60 months was 22%, 9% and 7%, versus outpatient OS of 43%, 20% and 9%, (each p<0.0001). Median PFS and OS were longer for outpatients, 212 versus 161 days, (p=0.0035) and 321 versus 192 days, (p=0.0003). Patients with poorer ECOG PS had shorter PFS and OS; with a median PFS for PS 0, 1-2, 3-4 of 316, 203 and 147 days, (p<0.0001) and median OS for PS 0, 1-2 and 3-4 of 498, 303 and 179 days, (p<0.0001). On multivariate analysis, ECOG PS was an independent predictor of outcome, (p=0.0005) while site of first CT was not significant when ECOG PS was included, (p=0.3494).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Although SCLC patients initially treated as inpatients had shorter PFS and OS, some experienced long term survival, including a 7% five-year survival. CT toxicities were not more common for inpatients. This validates that administration of CT in hospital can be considered as these patients may have a meaningful long-term response to therapy if properly selected. As previously identified in the literature, this data demonstrated that patients with poorer ECOG PS have shorter PFS and OS.

    6f8b794f3246b0c1e1780bb4d4d5dc53

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