Author of

• 31401

  +

  P2.12 - Small Cell Lung Cancer/NET (ID 180)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Small Cell Lung Cancer/NET
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31407

    +

    P2.12-06 - Factors of Importance for Survival After Platinum Re-Challenge in Platinum-Sensitive Small-Cell Lung Cancer Patients (ID 2609)

    10:15 - 18:15  |  Author(s): Fang Fang
    • Abstract

    Background
    

    Small-cell lung cancer (SCLC) patients showing sensitivity to platinum-based chemotherapy (PDCT) are usually offered the same combination at the time of tumor progression, if this occurs >3 months after the completion of the first-line treatment. However, no decision tools are available to predict what patients might benefit most from this approach. The aim of the present study was to investigate if certain clinical factors could be of prognostic relevance for re-challenge of PDCT in previously platinum-sensitive patients

    Method
    

    This retrospective study was based on patients diagnosed with SCLC in Sweden between January 2008 and February 2016. The study included patients who had received ≥ 1 cycle of PDCT in the 1^st and 2^nd line setting, respectively, and had “sensitive relapse”, which was defined as PFS ≥180 days after the start of first-line PDCT. The following baseline characteristics were collected; Age, Gender, Stage of the disease, presence of Brain metastasis, treatment with Consolidating thoracic radiotherapy or Prophylactic brain irradiation (PCI) after completion of 1^st line PDCT and “Sensitivity days”, which was defined as the interval between the initiation of 1^st and 2^nd line PDCT, respectively. In addition, Performance status (PS) and Laboratory values (Hb, Na, C-reactive protein, Albumin, LDH) before starting 2^nd line PDCT were compiled. The uni- and multi-variate analyses were performed using the cox proportional hazards regression model to assess the relationship between clinical characteristics and prognosis. Overall survival was defined as the interval between the initiation of 2^nd line until death due to any cause.

    Result
    

    The patient cohort consisted of 101 subjects. The distribution of baseline characteristics was as follows: male/female 46/55, median age (IQR) 68y (61-72), Stage II/III/IV 3/41/57, Brain metastases present/absent 39/62, Thoracic radiotherapy Y/N 30/71, PCI Y/N 52/49, median Sensitivity days (IQR) 399 days (307-511), PS 0/1/2/3 23/38/36/4. The statistically significant independent prognostic factors for overall survival on the multivariate model were PS, LDH values (HR, 95% CI for unit increase 2.10, 1.13-3.91), PCI (HR, 95% CI for presence vs absence 0.27, 0.13-0.56) and “Sensitivity days” (HR, 95% CI for unit increase 0.15, 0.07-0.32).

    Conclusion
    

    The results of this retrospective data analysis suggest that besides PS, other clinical factors that showed robust prognostic relevance for re-challenge with PDCT in platinum-sensitive SCLC are baseline LDH values, the time elapsed between the start of 1^st-line PDCT until the start of 2^nd-line PDCT, which we have defined as “Sensitivity days”, and the administration of PCI after completion of 1^st-line chemotherapy. These elements might potentially be taken into consideration for patient selection in this setting.