Platinum-doublet chemotherapy as second-line treatment for relapsed patients with small-cell lung cancer: A systematic review and meta-analysis

Horiuchi, Katsuhiro; Sato, Takashi; Kuno, Toshiki; Takagi, Hisato; Hirsch, Fred R.; Powell, Charles A.; Fukunaga, Koichi

doi:10.1016/j.lungcan.2021.04.013

Cited by 8 publications

(7 citation statements)

References 48 publications

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“…From the first-line and second-line therapy to consolidation therapy, immunotherapy has shown great potential in the individualized and precise treatment of lung cancer [29]. Malignant tumor cells can express PD-L1 through two mechanisms: one is congenital immune resistance, that is, in some tumors, component carcinogenic signal transduction directly upregulates the expression of PD-L1 on all tumor cells, which is a genetic event and has nothing to do with inflammatory stimulation [30][31][32]. The second is adaptive immune resistance, that is, the expression of PD-L1 induced by inflammatory signals (such as interferon γ) generated by antitumor immune response [33].…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Clinical Efficacy and Safety Analysis of PD‐1/PD‐L1 Inhibitor vs. Chemotherapy in the Treatment of Advanced Non‐Small‐Cell Lung Cancer: A Systematic Review and Meta‐Analysis

Guo

Zhang

Wang

et al. 2022

BioMed Research International

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Objective. To systematically evaluate the efficacy and safety of pembrolizumab (PD-1/PD-L inhibitor) and adjuvant chemotherapy to treat NSCLC and provide evidence-based reference for clinical use. Methods. By searching the Cochrane Library, EMBASE, PubMed, and Web of Science, according to the inclusion criteria, literature selection, data extraction, and quality evaluation were carried out for the included literature. The I2 test was used to evaluate heterogeneity between studies, and the meta-analysis was performed using RevMan 5.3 software provided by Cochrane. Results. Finally, 14 relevant documents meeting the standards were included. It is a statistical difference in one-year survival rate [ OR = 1.50 , 95% CI (1.28, 1.76), P < 0.00001 , I 2 = 0 %, Z = 4.99 ]; overall response rate[OR =1.57, 95% CI (1.29, 1.90), P < 0.00001 , I 2 = 0 %, Z = 4.58 ]; progression-free survival [ OR = 2.99 , 95% CI (2.29, 3.91), P < 0.00001 , I 2 = 26 %, Z = 8.00 ]; and overall survival [ OR = 1.38 , 95% CI (1.07, 1.78), P = 0.01 , I 2 = 46 %, Z = 2.50 ] and reduces the incidence of adverse drug reactions [ OR = 2.54 , 95% CI (1.99, 3.25), P < 0.00001 , I 2 = 69 %, Z = 7.43 ]. Conclusion. Pembrolizumab adjuvant chemotherapy is effective in the treatment of advanced NSCLC, but attention should be paid to the occurrence of adverse reactions in clinical. Due to the limitations of the methodology included in the study, this conclusion required more validation of large-sample RCT.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Clinical Efficacy and Safety Analysis of PD‐1/PD‐L1 Inhibitor vs. Chemotherapy in the Treatment of Advanced Non‐Small‐Cell Lung Cancer: A Systematic Review and Meta‐Analysis

Guo

Zhang

Wang

et al. 2022

BioMed Research International

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“…Although the effect of AMR after ICI treatment for SCLC was not as good as expected, our study suggested that AMR was significantly more effective in patients who showed sensitive relapse to first‐line ICI‐containing regimens. Recently, a systematic review also suggests platinum‐doublet regimens may be more effective than AMR or topotecan, the current standard of care for second‐line therapy, especially for sensitive relapse 30 . A randomized phase III trial also reported that carboplatin plus etoposide significantly prolonged PFS compared with topotecan monotherapy for sensitive relapse (4.7 vs 2.7 months) 31 .…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of amrubicin in patients with small cell lung cancer relapse after first‐line treatment including immune checkpoint inhibitors: A retrospective multicenter study (TOPGAN 2021‐01)

et al. 2022

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Background The therapeutic efficacy of cytotoxic anticancer drugs has been reported to be enhanced after immune checkpoint inhibitors (ICI) in non–small cell lung cancer; however, it is unclear whether the same is applicable for small cell lung cancer (SCLC). We evaluated the efficacy of second‐line amrubicin (AMR) following first‐line platinum‐based chemotherapy and ICI combination therapy (chemo‐ICI) in SCLC. Patients and Methods We retrospectively enrolled consecutive patients with SCLC treated with AMR as a second‐line following chemo‐ICI as first‐line between July 2019 and April 2021 from 16 institutions throughout Japan. We investigated the therapeutic effectiveness, safety, and efficacy‐enhancing variables of AMR. Results Overall, 89 patients treated with AMR after first‐line chemo‐ICI were analyzed. The overall response rate (ORR) was 29.2% (95% confidence intervals [CI], 20.1–39.8) and median PFS (m PFS) was 2.99 months (95% CI, 2.27–3.65). Patients who relapsed more than 90 days after receiving first‐line platinum combination therapy (sensitive relapse) exhibited greater ORR (58.3% vs. 24.7%, p = 0.035) and m PFS (5.03 vs. 2.56 months, p = 0.019) than patients who relapsed in <90 days (refractory relapse). Grade 3 or higher adverse events were mainly hematological toxicity. Conclusions Our study suggested that the therapeutic effect of AMR was not enhanced after ICI on SCLC. However, AMR may be effective in cases of sensitive relapse after chemo‐ICI. There was no increase in severe toxicity associated with AMR after ICI.

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“…The treatment of progressed SCLC is a challenge, especially in those who are resistant to first-line chemotherapy, because of the lack of effective second-line treatment [ 10 , 11 , 12 , 13 ]. Previous studies have suggested that chemosensitivity is an independent risk factor and is associated with survival time and the response to second-line therapy in patients with relapsed SCLC.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Chemosensitivity on the Outcome of Brain Metastases in Small-Cell Lung Cancer: A Retrospective Analysis

Meng

Tian

et al. 2022

Current Oncology

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Purpose: The purpose of this study was to investigate the prognostic differences between patients with small-cell lung cancer (SCLC) with different chemosensitivity to first-line chemotherapy who developed brain metastasis (BM) as the first site of progression. Methods: Patients with a BM after first-line treatment in the Tianjin Cancer Hospital were retrospectively analyzed. According to the time-free interval (TFI) between the completion of first-line chemotherapy and the onset of the BM, the patients were divided into the chemo-sensitive group (TFI ≥ 90 days, n = 145) and the chemo-resistant group (TFI < 90 days, n = 97). The survival time, which was calculated from the diagnosis of the BM, was analyzed after the onset of brain metastasis (BM-OS). Survival curves were plotted using the Kaplan–Meier method, and differences between groups were compared using the log-rank test. Results: In total, the median BM-OS was 8.4 months. The median BM-OS in the chemo-sensitive group was 8.8 months, and it was 8.0 months in the chemo-resistant group (p = 0.538). In patients without extracranial progression (n = 193), the median BM-OSes in the chemo-sensitive and chemo-resistant groups were 9.4 months and 9.7 months, respectively (p = 0.947). In patients with extracranial progression (n = 49), the median BM-OSes in the chemo-sensitive and chemo-resistant groups were 5.4 months and 4.2 months, respectively (p = 0.161). Conclusion: After the development of a BM as the first site of progression following chemotherapy in patients with SCLC, the prognosis of chemo-sensitive patients was not necessarily superior to chemo-resistant patients, especially in patients without extracranial progression.

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Platinum-doublet chemotherapy as second-line treatment for relapsed patients with small-cell lung cancer: A systematic review and meta-analysis

Cited by 8 publications

References 48 publications

[Retracted] Clinical Efficacy and Safety Analysis of PD‐1/PD‐L1 Inhibitor vs. Chemotherapy in the Treatment of Advanced Non‐Small‐Cell Lung Cancer: A Systematic Review and Meta‐Analysis

[Retracted] Clinical Efficacy and Safety Analysis of PD‐1/PD‐L1 Inhibitor vs. Chemotherapy in the Treatment of Advanced Non‐Small‐Cell Lung Cancer: A Systematic Review and Meta‐Analysis

Clinical efficacy of amrubicin in patients with small cell lung cancer relapse after first‐line treatment including immune checkpoint inhibitors: A retrospective multicenter study (TOPGAN 2021‐01)

The Impact of Chemosensitivity on the Outcome of Brain Metastases in Small-Cell Lung Cancer: A Retrospective Analysis

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