Managing Patients With Relapsed Small-Cell Lung Cancer

Gong, Jun; Salgia, Ravi

doi:10.1200/jop.18.00204

Cited by 45 publications

(34 citation statements)

References 49 publications

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“…The importance of surgery in the treatment early-stage SCLC has been widely acknowledged (19, 21, 22). And for SCLC patients at relatively advanced limited-stage, concurrent chemo-radiotherapy is greatly recommended (23, 24). Recent advances in radiology have enabled the early diagnosis of SCLC, and have prompted us to re-evaluate the effectiveness of surgery in SCLC.…”

Section: Discussionmentioning

confidence: 99%

Surgery as a Potential Treatment Option for Patients With Stage III Small-Cell Lung Cancer: A Propensity Score Matching Analysis

Zhang

Shang

et al. 2019

Front. Oncol.

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Surgery is commonly recommended for patients with stage I small-cell lung cancer (SCLC), whereas chemotherapy and radiotherapy are considered the standard treatment for patients with stage III SCLC. However, recent studies have suggested that a small proportion of patients with SCLC at an advanced stage may benefit from surgical resection. Therefore, in this study, we investigated the effectiveness of surgery in patients with stage III SCLC. Patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2013. Propensity score matching (PSM) was used to eliminate any clinical bias. The overall survival (OS) was determined using the Kaplan–Meier method and compared using the log-rank test. The Cox proportional-hazards model was used to identify the effect of surgery on the OS. Of 9606 patients with stage III SCLC, 234 underwent surgery. Compared with the non-surgical group, a higher proportion of patients undergoing surgery had T1 and N0-N1 disease (risen by 10.7% for T1; 12.6% for N0-N1) and a lower proportion had T4 and N3 disease (decreased by 14.3% for T4; 12.5% for N3). The Kaplan-Meier analysis showed that patients who underwent surgery had a better OS before and after PSM. The multivariate analysis showed that surgery was beneficial for patients with stage III SCLC (HR: 0.651, 95% CI 0.524–0.808, P < 0.001). In conclusion, surgical resection might be associated with improved OS for patients with stage III SCLC and may be considered for the treatment of these patients. Further prospective studies are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Surgery as a Potential Treatment Option for Patients With Stage III Small-Cell Lung Cancer: A Propensity Score Matching Analysis

Zhang

Shang

et al. 2019

Front. Oncol.

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“…An alternative is the combination CAV: cyclophosphamide-doxorubicin-vincristine (II, B). Other agents commonly used based on phase 2 trials are irinotecan, taxanes, gemcitabine, vinorelbine, or temozolomide [32]. Only around 20% of SCLC patients will receive the third-line therapy with modest results.…”

Section: Systemic Regimens For Es-sclc First Linementioning

confidence: 99%

SEOM clinical guidelines for the treatment of small-cell lung cancer (SCLC) (2019)

et al. 2020

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Small-cell lung cancer (SCLC) accounts for 15% of lung cancers. Only one-third of patients are diagnosed at limited stage. The median survival remains to be around 15-20 months without significative changes in the strategies of treatment for many years. In stage I and IIA, the standard treatment is the surgery followed by adjuvant therapy with platinum-etoposide. In stage IIB-IIIC, the recommended treatment is early concurrent chemotherapy with platinum-etoposide plus thoracic radiotherapy followed by prophylactic cranial irradiation in patients without progression. However, in the extensive stage, significant advances have been observed adding immunotherapy to platinum-etoposide chemotherapy to obtain a significant increase in overall survival, constituting the new recommended standard of care. In the second-line treatment, topotecan remains as the standard treatment. Reinduction with platinum-etoposide is the recommended regimen in patients with sensitive relapse (≥ 3 months) and new drugs such as lurbinectedin and immunotherapy are new treatment options. New biomarkers and new clinical trials designed according to the new classification of SCLC subtypes defined by distinct gene expression profiles are necessary.

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“…SCLC remains a deadly disease, even as early as possible in the discovery and improvement of treatment options [18]. This study found that serum OPN levels in patients with SCLC were higher than in healthy controls.…”

Section: Discussionmentioning

confidence: 66%

Prognostic significance of serum osteopontin levels in small-cell lung cancer

Wang

et al. 2020

Preprint

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BackgroudOsteopontin (OPN) is involved in the development and metastasis of a variety of tumors. This study explored serum OPN levels in patients with small cell lung cancer (SCLC) and compared them with healthy controls.MethodsThe OPN levels of 96 patients with SCLC before and after first-line chemotherapy were detected by enzyme-linked immunosorbent assay (ELISA) and compared with 60 healthy controls.ResultsThe pre-treatment serum OPN levels of patients with SCLC were higher than those of healthy controls (P<0.001). Serum OPN levels were significantly associated with disease stage, tumor size, and lymph node metastasis (P=0.012, 0.034, and 0.037, respectively). Serum OPN levels were significantly decreased after first-line chemotherapy (P=0.019), which was associated with treatment response (P=0.011), but there was no significant difference with pre-treatment OPN levels (P=0.485). Cox proportional hazard analysis showed that serum OPN levels, disease stage, and performance status were independent predictors of overall survival.ConclusionsOur results suggest that serum OPN levels can be used as biomarkers to predict treatment response and survival in patients with SCLC.

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Managing Patients With Relapsed Small-Cell Lung Cancer

Cited by 45 publications

References 49 publications

Surgery as a Potential Treatment Option for Patients With Stage III Small-Cell Lung Cancer: A Propensity Score Matching Analysis

Surgery as a Potential Treatment Option for Patients With Stage III Small-Cell Lung Cancer: A Propensity Score Matching Analysis

SEOM clinical guidelines for the treatment of small-cell lung cancer (SCLC) (2019)

Prognostic significance of serum osteopontin levels in small-cell lung cancer

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