Performance status and sensitivity to first‐line chemotherapy are significant prognostic factors in patients with recurrent small cell lung cancer receiving second‐line chemotherapy

Abstract

BACKGROUND To the authors' knowledge, the prognostic factors in recurrent small cell lung cancer (SCLC) patients treated with second‐line chemotherapy have not yet been clearly identified to date. METHODS Between July 1992 and December 2003, 232 of 515 patients who were diagnosed to have SCLC at the National Cancer Center Hospital East were administered second‐line chemotherapy for recurrent disease. The authors retrospectively analyzed the relation between clinical factors evaluated at the time of recurrence and the response to second‐line chemotherapy or survival in these patients. RESULTS The results of univariate analyses revealed that response was significantly associated with the performance status (PS) alone, whereas survival was significantly associated with the PS, disease extent, and sensitivity to first‐line chemotherapy. Multivariate analysis identified PS (P < .0001) and sensitivity to first‐line chemotherapy (P = .0024) as the independent prognostic factors for survival. When the patients were grouped according to these 2 significant prognostic factors, the survival of patients with a PS of 0 to 1 was significantly better than that of the patients with a PS of 2 to 4 both among cases that were sensitive and those that were refractory to first‐line chemotherapy. Although the survival of sensitive recurrent cases was significantly better than that of the refractory recurrent cases among the patients with a PS of 0 to 1 patients, no survival difference was observed between the sensitive and refractory recurrent cases in the patients with a PS of 2 to 4. CONCLUSIONS Both PS and sensitivity to initial chemotherapy were found to be significant prognostic factors for survival in recurrent SCLC patients treated with second‐line chemotherapy. These 2 factors should therefore be used as stratification factors in future clinical trials. Cancer 2008. © 2008 American Cancer Society.

Retrospective analysis of Japanese patients with relapse or refractory small-cell lung cancer treated with amrubicin hydrochloride

“…Multivariate analysis demonstrated that PS of 0-1 or 2-4 for AMR, and the relapse pattern (sensitive or refractory) were both independent prognostic factors for OS. The results were consistent with our previous study (12).…”

Outcomes of small-cell lung cancer patients treated with second-line chemotherapy: A multi-institutional retrospective analysis

“…Consistently with previous data, Kim et al recently reported the results of a retrospective analysis evaluating the relationship between clinical factors at the time of recurrence and response to second-line chemotherapy and survival in SCLC patients [25]. Univariate analysis showed that response was significantly associated with PS alone, whereas survival was significantly associated with PS, disease extent, and sensitivity to first-line chemotherapy.…”

Targeting DNA damage in SCLC

“…Around 30% of patients have primary chemoresistant or refractory tumours and the probability of response to second-line chemotherapy can be predicted according to response to first-line treatment and the time to progression after completing it [11][12][13][14]. Patients with SCLC that relapse during first line platinum combination therapy or who have a treatment free interval of 60-90 days or less after the end of first-line therapy (resistant/refractory disease) have a worse outcome compared to those relapsing more than 90 days after completion of first-line therapy (sensitive disease) [11,13,15]. Due to the increasing tumour resistance to second line treatment and often rapid clinical deterioration during or following second line treatment, very few patients receive a third line of therapy.…”