Randomized Phase II Trial of Pemetrexed Combined With Either Cisplatin or Carboplatin in Untreated Extensive-Stage Small-Cell Lung Cancer

Socinski, Mark A.; Weissman, Charles; Hart, Lowell L.; Beck, J. Thaddeus; Choksi, J. K.; Hanson, John; Prager, Denis J.; Monberg, Matthew J.; Ye, Zhishen; Obasaju, Coleman K.

doi:10.1200/jco.2006.07.7016

Cited by 73 publications

(60 citation statements)

References 34 publications

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“…Over recent decades, numerous biological targets such as targeted agents and new cytotoxic drugs for NSCLC have been identified for anticancer therapies and significant progress has been made in the treatment of malignancies (Sandler et al 2006;Socinski et al 2006;Mok et al 2009). However, little progress has been made in the treatment of SCLC and no targeted agents have prolonged the OS for SCLC patients.…”

Section: Discussionmentioning

confidence: 99%

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Hong

Cui

Wang

et al. 2015

Tohoku J. Exp. Med.

271

239

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Small cell lung cancer (SCLC) is an aggressive disease characterized by rapid growth and metastases. It has been recognized that the inflammation of the microenvironment plays a critical role in the development of malignancies. However, little is known about the role of multiple inflammatory and hematological markers in the prognosis of SCLC. The aim of this study was to determine the clinical significance of pre-treatment inflammation-based scores and characteristics as prognostic indicators for the survival of SCLC patients. A retrospective analysis of 919 SCLC cases was performed. Patients' characteristics and hematologic tests data at initial diagnosis were collected. The univariate analysis of all SCLC patients indicated that favorable prognostic factors were age ˂ 70 years, non-smokers, good performance status, limited disease and response to treatment. Moreover, univariate analysis of inflammation-based scores and other blood parameters showed that neutrophil-lymphocyte ratio ≥ 5, platelet-lymphocyte ratio ≥ 250, systemic immune-inflammation index (SII) ≥ 1,600 × 10 9 /L, prognostic nutritional index (albumin + 5 × lymphocyte) < 45, and elevated serum lactate dehydrogenase (LDH) predicted poor prognosis in SCLC patients. SII represents the score that is calculated as follows: platelet count × neutrophil count/lymphocyte count. In the multivariate analysis, SII, together with serum LDH, stage and response to therapy, were associated with overall survival (OS). This study demonstrated that the combination of platelet count and neutrophil-lymphocyte ratio could help to predict poor prognosis in SCLC. Our findings will facilitate the understanding of survival differences in SCLC patients in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Hong

Cui

Wang

et al. 2015

Tohoku J. Exp. Med.

271

239

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“…Data from phase I and II trials suggested antitumoural activity and toxicity comparable to standard treatment regimens with EP or cisplatin/irinotecan [25].…”

Section: Alternatives To Platin/etoposidementioning

confidence: 97%

Treatment of extensive-stage small cell lung carcinoma: current status and future prospects

Demedts

Vermaelen²,

Meerbeeck³

2009

Eur Respir J

185

162

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Small cell lung cancer (SCLC) is an aggressive lung tumour strongly associated with cigarette smoking, with patients often presenting with metastatic disease at the time of diagnosis. Although SCLC is very chemoradiosensitive and high response rates are obtained with treatment, relapse rates are high and the prognosis remains very poor.In limited-stage SCLC, the overall survival rate has been significantly improved by adding dosehyperfractionated thoracic radiotherapy and prophylactic cranial irradiation to systemic chemotherapy. In contrast, little progress has been made in the treatment of extensive-stage SCLC (ES-SCLC), apart from the recently documented survival gain by the addition of prophylactic cranial irradiation.First-line therapy in ES-SCLC currently consists of chemotherapy, combining a platinum drug with either etoposide or irinotecan as a possible alternative.New treatments are needed in order to improve the prognosis of ES-SCLC, as median survival with current standard treatment is still only 9-10 months from diagnosis. The present review focuses on the management of ES-SCLC, with special attention to the development of new treatment options.KEYWORDS: Chemotherapy, extensive disease, radiotherapy, small cell lung cancer, treatment S mall cell lung cancer (SCLC) is an aggressive malignant disease, with the majority of patients presenting with distant metastasis at diagnosis. A separate staging system has been developed for SCLC, classifying SCLC as limited or extensive disease [1]. The International Association for the Study of Lung Cancer defines limited-stage SCLC (LS-SCLC) as: ''disease restricted to one hemithorax with regional lymph node metastases, including hilar, ipsilateral and contralateral mediastinal, and ipsilateral and contralateral supraclavicular nodes and should also include patients with ipsilateral pleural effusion independent of whether cytology is positive or negative '' [2]. Patients with SCLC who do not fit this definition are considered to have extensive-stage SCLC (ES-SCLC). This staging system was used to select the appropriate treatment regimen: chemotherapy in combination with thoracic radiotherapy in patients with LS-SCLC, and chemotherapy alone in patients with ES-SCLC. Recent data suggest that the tumour, node, metastasis classification traditionally reserved for the staging of nonsmall cell lung cancer (NSCLC) can also be applied for the staging of SCLC [3].

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“…SCLC is an extremely aggressive malignancy, with significantly shortened doubling time, higher growth fraction, and earlier onset of remote metastasis, is usually sensitive to chemotherapy with an objective response rate of 80-90% (Schiller et al, 2001;Simon et al, 2003;Stupp et al, 2004;Socinski et al, 2006;Jemal et al, 2010). There is an intersection between SCLC and NSCLC that the WHO/IASLC classification in 1999 defined combined small cell lung carcinomas (C-SCLC).…”

Section: Introductionmentioning

confidence: 99%

Etoposide-Cisplatin Alternating with Vinorelbine-Cisplatin Versus Etoposide-Cisplatin Alone in Patients with Extensive Disease Combined with Small Cell Lung Cancer

Zhang

Qi²,

Zheng³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to evaluate the efficacy of alternating etoposide-cisplatin and vinorelbine-cisplatin (EP-NP) compared with an etoposide-cisplatin (EP) regimen for advanced combined small cell carcinomas. Materials and Methods: Histologically confirmed combined small cell carcinoma patients who met the inclusion criteria were randomly assigned (1:1) into either the EP-NP setting (group A) or the EP setting (group B). The primary endpoint was progression-free survival in patients who received at least one dose of treatment. Results: Eighty-two patients entered into this trial, 42 in group A and 40 in group B. The objective response rates in group A and group B were 42.9% and 32.5%, respectively (p=0.334). Survival analysis showed that median progression-free survival was 6.1 months in group A, which was significantly longer than the 4.1 months in group B (p=0.041). However, as to overall survival, no significant difference was found between the two groups (11.0 vs 10.1 months in groups A and B, respectively, p=0.545). No unexpected side effects were observed in either group. Conclusions: The EP-NP regimen for combined small cell carcinomas prolonged progressionfree survival compared with the EP regimen. Further clinical investigations are warranted.

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Randomized Phase II Trial of Pemetrexed Combined With Either Cisplatin or Carboplatin in Untreated Extensive-Stage Small-Cell Lung Cancer

Abstract: Pemetrexed/platinum doublets had activity and appeared to be well-tolerated in first-line ES-SCLC.

Cited by 73 publications

References 34 publications

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer

Treatment of extensive-stage small cell lung carcinoma: current status and future prospects

Etoposide-Cisplatin Alternating with Vinorelbine-Cisplatin Versus Etoposide-Cisplatin Alone in Patients with Extensive Disease Combined with Small Cell Lung Cancer

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