|Table of Contents|

Efficacy and prognostic factors analysis on small-cell lung cancer patients with second-line chemotherapy

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 15
Page:
2760-2766
Research Field:
Publishing date:

Info

Title:
Efficacy and prognostic factors analysis on small-cell lung cancer patients with second-line chemotherapy
Author(s):
LI Zhihua1; 2; LI Zhaoxia1; CHEN Junnan1; ZHA Haoran1; SHEN Wennan1; DONG Yuemei1; ZHAO Wei1; WANG Ning1; LIU Xiaoqing2
1.Department of Oncology,Characteristic Medical Center of the Rocket Force of PLA,Beijing 100088,China;2.Department of Medical Oncology,the Fifth Medical Center of PLA General Hospital,Beijing 100071,China.
Keywords:
SCLC; second-line chemotherapy; response rate; survival; influencing factors
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2024.15.011
Abstract:
Objective:To analyze the influence factors of the efficacy and survival outcomes of small-cell lung cancer(SCLC) patients received second-line chemotherapy,to provide some evidence for treating such patients in clinical practice.Methods:The clinical data and follow-up results of 152 SCLC patients received second-line chemotherapy from January 2010 to December 2014 were retrospectively analyzed.The Kaplan-Meier method survival curves were used to analysis survival benefit,and univariate analyse and Cox proportional hazards model were used to analyse prognostic factors of survival outcomes of the patients.Results:The objective response rate(ORR) of the SCLC patients who received second-line chemotherapy was 39.5%.The median progression-free survival(PFS) and overall survival(OS) from second-line chemotherapy were 3.1 months and 5.3 months.Curative effect of second-line chemotherapy was correlated with that of first-line chemotherapy(P＜0.001).The therapeutic response of second-line chemotherapy in the sensitive disease patients was better than that in the resistance or the refractory disease patients(P=0.003),and the median OS from second-line chemotherapy of the three groups patients were 5.5 months,5.3 months and 4.7 months,and with no statistic differences(P=0.071).The ECOG PS score at diagnosis and before second-line chemotherapy(P=0.001/0.001),as well as liver metastasis(P=0.001) and bone metastasis(P=0.007),were independent risk factors for PFS from second-line chemotherapy.The ECOG PS score before second-line chemotherapy(P=0.023/0.003) and liver metastasis(P=0.001) were independent risk factors for OS from second-line chemotherapy.Conclusion:The SCLC patients who obtained better efficacy in the first-line chemotherapy may gain better therapeutic response and survival benefit after second-line chemotherapy.The ECOG PS score at diagnosis and before second-line chemotherapy and liver metastasis were significant prognostic factors for the second-line chemotherapy.

References:

［1］BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2024,74(3):229-263.
［2］HERZOG BH,DEVARAKONDA S,GOVINDAN R.Overcoming chemotherapy resistance in SCLC［J］.J Thorac Oncol,2021,16(12):2002-2015.
［3］RUDIN CM,BRAMBILLA E,FAIVRE-FINN C,et al.Small-cell lung cancer［J］.Nat Rev Dis Primers,2021,7(1):3.
［4］尹一,黄章洲,黄韵坚,等.老年小细胞肺癌患者预后分析［J］.中华老年医学杂志,2019,38(12):1357-1362. YIN Yi,HUANG Zhangzhou,HUANG Yunjian,et al.Prognostic factor analysis of elderly patients with small-cell lung cancer［J］.Chin J Geriatr,2019,38(12):1357-1362.
［5］曹恒，宋学坤，洪永贵,等.老年广泛期小细胞肺癌患者的预后分析［J］.现代肿瘤医学，2020,28(3):411－415. CAO Heng,SONG Xuekun,HONG Yongkui,et al.Prognostic factors for the survival of extensive stage small cell lung cancer in elderly patients［J］.Modern Oncology,2020,28(3):411－415.
［6］ZUGAZAGOITIA JON,PAZ-ARES LUIS.Extensive-stage small-cell lung cancer:First-line and second-line treatment options［J］.J Clin Oncol,2022,40:671-680.
［7］KONDO R,WATANABE S,SHOJI S,et al.A phase Ⅱ study of irinotecan for patients with previously treated small cell lung cancer［J］.Oncology(Switzerland),2018,94:223-232.
［8］KIM SH,KIM MJ,KIM YJ,et al.Paclitaxel as third-line chemotherapy for small cell lung cancer failing both etoposide-and camptothecin-based chemotherapy［J］.Medicine(Baltimore),2017,96:e8176.
［9］PACHECO JM.Systemic therapy options following first-line chemoimmunotherapy in small-cell lung cancer［J］.J Thorac Dis,2020,12(10):6264-6274.
［10］阿丽亚?奥斯曼,王效刚,刘俊远,等.小细胞肺癌内科治疗新进展［J］.现代肿瘤医学,2023,31(7):1362-1366. ALIYA?AOSIMAN,WANG Xiaogang,LIU Junyuan,et al.Advances in the internal medicine treatment of small cell lung cancer［J］.Modern Oncology,2023,31(7):1362-1366.
［11］ANTONIA SJ,LPEZ-MARTIN JA,BENDELL J,et al.Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer(Checkmate 032):A multicentre,open-label phase 1/2 trial［J］.Lancet Oncol,2016,17:883-895.
［12］READY NE,OTT PA,HELLMANN MD,et al.Nivolumab monotherapy and nivolumab plus ipilimumab in recurrent small cell lung cancer:Results from the CheckMate 032 randomized cohort［J］.J Thorac Oncol,2020,15:426-435.
［13］CHUNG HC,LOPEZ-MARTIN JA,KAO S,et al.Phase 2 study of pembrolizumab in advanced small-cell lung cancer(SCLC):KEYNOTE-158［abstract］［J］.J Clin Oncol,2018,36(Suppl):Abstract 8506.
［14］CHUNG HC,PIHA-PAUL SA,LOPEZ-MARTIN J,et al.Pembrolizumab after two or more lines of previous therapy in patients with recurrent or metastatic SCLC:Results from the KEYNOTE-028 and KEYNOTE-158 studies［J］.J Thorac Oncol,2020,15(4):618-627.
［15］KALEMKERIAN G,LOO B,AKERLEY W,et al.NCCN guidelines insights:Small cell lung cancer,version 2.2018［J］.J Natl Compr Canc Netw,2018,16(10):1171-1182.
［16］赫捷,李进,程颖,等.中国临床肿瘤学会(CSCO)小细胞肺癌诊疗指南2023［M］.北京:人民卫生出版社,2023:63-66. HE Jie,LI Jin,CHENG Ying,et al.Chinese Society of Clinical Oncology(CSCO) Small Cell Lung Cancer Guidelines 2023［M］.Beijing:People's Medical Publishing House,2023:63-66.
［17］RECK M,LIU SV,MANSFIELD AS,et al.IMpower133:Updated overall survival(OS) analysis of first-line(1L) atezolizumab(atezo)+carboplatin+etoposide in extensive-stage SCLC(ES-SCLC)［J］.Annals of Oncology,Elsevier,2019,30(5):710-711.
［18］ACHEAMPONG E,ABED A,MORICI M,et al.Tumor PD-L1 expression in small-cell lung cancer:A systematic review and Meta-analysis［J］.Cells,2020,9(11):E2393.
［19］GANDARA DR,PAUL SM,KOWANETZ M,et al.Blood-based tumor mutational burden as a predictor of clinical benefit in non-small cell lung cancer patients treated with atezolizumab［J］.Nat Med,2018,24(9):1441-1448.
［20］XU Y,HUANG Z,FANG J,et al.Tolerability,safety,and preliminary antitumor activity of fuzuloparib in combination with SHR-1316 in patients with relapsed small cell lung cancer:A multicenter,open-label,two-stage,phase Ⅰb trial［J］.Transl Lung Cancer Res,2022,11(6):1069-1078.
［21］KNELSON EH,PATEL SA,SANDS JM.PARP inhibitors in small-cell lung cancer:Rational combinations to improve responses［J］.Cancers(Basel),2021,13(4):727.
［22］王浩,郭俊俊,王锋刚,等.93例广泛期小细胞肺癌(SCLC)综合治疗的预后因素分析［J］.现代肿瘤医学,2014,22(10):2315-2318. WANG Hao,GUO Junjun,WANG Fenggang,et al.Multivariate analysis of prognostic factors in 93 patients with extensive-stage small cell lung cancer(SCLC)［J］.Modern Oncology,2014,22(10):2315-2318.
［23］ANTONIO R,PAOLA CS,ASSUNTA S,et al.Optimal drugs for second-line treatment of patients with small-cell lung cancer［J］.Expert Opinion on Pharmacotherapy,2016,7(17):969-976.
［24］YOUNG HK,KOICHI G,KIYOTAKA Y,et al.Performance status and sensitivity to first-line chemotherapy are significant prognostic factors in patients with recurrent small cell lung cancer receiving second-line chemotherapy［J］.Cancer,2008,113(9):2518-2523.
［25］HLNE NM,PASCALE G,LUCILE V,et al.Outcomes in recurrent small-cell lung cancer after one to four chemotherapy lines:A retrospective study of 300 patients［J］.Lung Cancer,2012,78(1):112-120.
［26］MOSER SS,BAR J,KAN I,et al.Real world analysis of small cell lung cancer patients:Prognostic factors and treatment outcomes［J］.Curr Oncol,2021,28(1):317-331.
［27］武春秋,张允清.CONUT评分对广泛期小细胞肺癌放化疗患者预后的预测价值［J］.临床肿瘤学杂志,2023,28(3):235-240. WU Chunqiu,ZHANG Yunqing.The prognostic value of CONUT score in patients with extensive small cell lung cancer treated with chemoradiotherapy［J］.Journal of Clinical Oncology,2023,28(3):235-240.
［28］MIURA Y,IMAI H,SAKURAI R,et al.The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer［J］.Med Oncol,2018,35(4):45．
［29］杨燕,程倩倩,王威,等.LMR对广泛期小细胞肺癌一线化疗疗效和预后的预测价值［J］.蚌埠医学院学报,2023,48(1):104-109. YANG Yan,CHENG Qianqian,WANG Wei,et al.Predictive value of LMR for efficacy and prognosis of first-line chemotherapy for extensive-stage small cell lung cancer［J］.J Bengbu Medical College,2023,48(1):104-109.

Memo

Memo:
National Natural Science Foundation of China(No.31900627);国家自然科学基金青年项目(编号:31900627)
Last Update: 2024-06-28