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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
- Presentations: 1
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
P1.12-12 - A Systematic Review and Meta-Analysis of Early and Late Survival Following Anti-Cancer Therapies for Small Cell Lung Cancer (ID 13476)
16:45 - 18:00 | Author(s): Kelly Elimian
Treatments for small cell lung cancer (SCLC) have not changed significantly in contrast to non-small cell where it is more individually tailored. Current guidelines generally have a one size fits all approach to chemotherapy. We conducted the largest systematic review and meta-analysis in SCLC to evaluate early and median survival by different study factors.a9ded1e5ce5d75814730bb4caaf49419 Method
We searched EMBASE and MEDLINE for randomized controlled trials and observational cohort studies which reported survival following platinum doublet chemotherapy for SCLC. We calculated overall survival at 30 and 90 days along with the median survival.4c3880bb027f159e801041b1021e88e8 Result
We identified 10,487 titles, 161 were included. Cisplatin + etoposide (n=87 (49.4%)), carboplatin + etoposide (n=36 (20.5%)) and cisplatin + irinotecan (n=23 (13.1%)) were predominantly reported. The commonly reported cause of death within 30 days was neutropaenic sepsis (n=27), disease progression (n=11) and cardiovascular (n=8). Across both stages 30-day survival was 98% (95% CI 98-99%) whilst 90-day was 95% (95% CI 94-96%). Thirty and 90-day survival showed similar patterns to study factors as median survival (summarised in Table 1).
Limited stage median survival was 18.1 months (95% CI 17.0-19.1). Studies that administered thoracic radiotherapy and PCI had better survival than those that did not. Studies giving carboplatin + etoposide or included poorer PS (0-3) individuals had inferior survival. PCI timing did not show survival differences.
Extensive stage median survival was 9.6 months (95% CI 8.9-10.3). This was augmented in studies that gave irinotecan + cisplatin and were conducted in Asia. There were no survival differences by cisplatin/carboplatin or median participant age.
Neutropenic sepsis accounts for the majority of 30-day deaths and was mostly reported with cisplatin + etoposide. Our findings broadly support guideline recommendations but suggest certain sub-populations e.g. Asian individuals, benefit from targeted treatment with irinotecan + cisplatin. Age should be re-considered as a treatment-deciding factor in extensive stage.6f8b794f3246b0c1e1780bb4d4d5dc53
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