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Kevin Chen



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    EP1.12 - Small Cell Lung Cancer/NET (ID 202)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 2
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.12-19 - Characteristics of Patients with Small-Cell Lung Cancer in the Real-World: A Systematic Review (Now Available) (ID 1842)

      08:00 - 18:00  |  Author(s): Kevin Chen

      • Abstract
      • Slides

      Background

      Patients with poor performance status (PS) ≥2 are generally underrepresented in clinical trials. Describing patients’ characteristics outside clinical trials setting would help better characterize unmet needs. This study aimed to assess the characteristics of SCLC patients, overall and according to sub-types; extensive-stage (ES) and limited-stage (LS).

      Method

      A systematic review of observational studies was conducted using MEDLINE and Embase databases between January 1998 and October 2018. Pragmatic searches of the grey literature were conducted to identify additional sources. Studies reporting epidemiological data on SCLC were independently screened, adjudicated and data were abstracted by two assessors, with conflicts resolved by a third.

      Result

      Of the 2,418 sources identified, 394 were reviewed in depth and 140 were retained. An additional 28 sources were identified through pragmatic searches yielding a total of 168. Median age at diagnosis (reported in 32 studies) ranged from 54 to 74 years. Sex distribution was reported in 86 studies, with a male predominance irrespective of stage. Eastern Cooperative Oncology Group PS was reported in 30 studies. The majority of studies were hospital-based (n=28, 93%) and data mainly originated from medical records or chart review (22, 73%). PS was assessed at baseline or at the time of diagnosis in 26 studies. Twenty-three (77%) studies reported poor PS status for ≥25% of the SCLC population, with six reporting poor PS in ≥50% of the SCLC population. The proportion of SCLC patients with poor PS ranged from 14% to 88%. Findings were heterogeneous across studies due to the variability in thresholds used to define the categories, study setting and inclusion of both LS- and ES-SCLC patients for reporting. For studies reporting PS by stage (n=4), the proportion of patients with poor PS ranged from 13% to 53% in ES-SCLC and 11% to 12% in LS-SCLC.

      Conclusion

      A significant percentage of patients with SCLC outside clinical trials present with a poor PS. LS-SCLC patients have a better PS. Prevalence of poor PS was higher for ES-SCLC and the reported figures are higher compared to non-small cell lung cancer.

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      EP1.12-39 - Survival and Prognostic Factors in Patients with Small-Cell Lung Cancer: A Systematic Review of Observational Studies (Now Available) (ID 1824)

      08:00 - 18:00  |  Author(s): Kevin Chen

      • Abstract
      • Slides

      Background

      With limited advances in the management of small-cell lung cancer (SCLC) within the past thirty years, SCLC still imposes a substantial burden. Identification of prognostic factors help optimize development of appropriate treatment strategies. As part of a larger systematic review, this study aimed to describe survival and prognostic factors in SCLC.

      Method

      A systematic review of observational studies was conducted using MEDLINE and Embase over the period 01 January 1998‒17 October 2018. Pragmatic searches of the grey literature, including conference abstracts and proceedings, were also conducted to identify additional sources. Search outputs were independently screened, adjudicated and abstracted by two assessors independently, with conflicts resolved by a third.

      Result

      Of the 2,418 sources identified in the literature, 394 were retained for full text review, out of which 140 were included. In addition, 28 were identified through pragmatic searches yielding a total of 168 sources. Data mainly originated from Asia-Pacific (51; 42.2%), North America (30; 24.8%) and Europe (29; 24%). Eight different measures of survival were used across 121 studies (102 overall, 40 limited-stage [LS]-SCLC and 42 extensive-stage [ES]-SCLC): median overall survival (OS) was the most commonly reported, followed by 1- and 5-year survival rates. A total of 71/102 (69.6%) studies on SCLC, 19/40 (47.5%) on LS-, and 17/42 (40.5%) on ES-SCLC reported median OS. In SCLC, the median OS ranged from 4.6 to 29.1 months, while it ranged from 10 to 47 months in LS-SCLC and from 4 to 14.2 months in ES-SCLC. Survival trend was reported in three studies using data from SEER registries with a general trend towards an increase in survival rate when 2- and 5-year survival rates were reported. When reported (one source), no improvement in OS trend was noted. Chemotherapy, radiation therapy, prophylactic cranial irradiation, performance status, age and sex were among prognostic factors identified in both stages of SCLC.

      Conclusion

      SCLC survival rate is low yet variable with significantly lower rates in ES-SCLC and minimal changes in survival trend. Significant variability exists in measurement and reporting SCLC survival and survival trend, thus hampering comparability of findings, syntheses of findings and clinical decision-making.

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