Similar survival benefits of a good response and stable disease to platinum-based chemotherapy in non-small cell lung cancer

Abstract

Abstract. The present study aimed to evaluate the similar survival benefits of a good response [complete response or partial response (CR/PR)] and stable disease (SD) to chemotherapy in non-small cell lung cancer (NSCLC) patients in clinical practice. All 322 patients who were treated between 1999 and 2012 with first-line platinum-based chemotherapy were retrospectively analyzed. Tumor responses were classified according to the response evaluation criteria for solid tumors. A total of 67 (20.8%) patients experienced CR/PR and 165 (51.2%) achieved SD. There was no difference in progression-free survival between the patients with CR/PR and those with SD (P= 0.347). There was also no difference between the two groups with regard to overall survival time (P= 0.878). In multivariate analysis, disease-control (more than SD) was one of the favorable prognostic factors. In clinical practice, a survival benefit would be provided not only for the patients who have good response, but also for those with SD. IntroductionThe incidence and mortality rates of lung cancer have increased globally during the last few decades (1,2). The majority of cases of lung cancer diagnosed were non-small cell lung cancer (NSCLC), and ~40% of patients with NSCLC are affected by advanced diseases (3). For patients with advanced NSCLC with a good performance status, systemic chemotherapy is the standard therapy at present. The first-line treatment for such patients is platinum-based chemotherapy, which improves symptom control, quality of life and survival as compared with best supportive care (4). A good response [complete response or partial response (CR/PR)] to chemotherapy has typically been equated with the clinical benefit of increased survival (5), but only 20-30% of patients achieve a good response in previous clinical trials, while 40-50% maintain a stable disease (SD) status (6-8). Certain previous studies reported that an initial good response and stable disease indicate similar survival benefits for chemotherapeutical patients with advanced NSCLC (9,10). The present retrospective study was undertaken to evaluate the similar survival benefits of a good response and stable disease to platinum-based chemotherapy in previously untreated NSCLC patients. Patients and methodsPatients. The patients enrolled in the present study were those consecutively diagnosed with NSCLC and treated with platinum-based chemotherapy as first-line treatment at the University of Tsukuba Hospital and Tsukuba Medical Center Hospital (both Tsukuba, Ibaraki, Japan) between January 1999 and December 2012. All the patients were histologically/cytologically confirmed as presenting with NSCLC and unresectable advanced disease. The histopathological diagnosis was defined by the World Health Organization classification (11), and patients were staged according to the Union for International Cancer Control tumor-node-metastasis system (12). Treatment and response.Enrolled patients received at least one cycle of cisplatin-or carboplatin-based chemotherapy. The clinical, ...

Association between epidermal growth factor receptor gene mutation status and short‑term efficacy of first‑line platinum‑containing chemotherapy in advanced non‑small cell lung cancer

“…EGFR is one of the most important drivers of NSCLC pathogenesis (23). EGFR gene mutations are major predictors of the efficacy of EGFR-TKIs in Asian patients with lung adenocarcinoma, where various studies have previously shown that patients with EGFR gene mutations tended to benefit more from concurrent treatment with EGFR-TKIs and standard first-line chemotherapy regimens (17,(24)(25)(26)(27)(28)(29). However, the relationship between the efficacy of chemotherapy and the EGFR gene status remains controversial.…”

Pressurized Intraperitoneal Aerosol Chemotherapy Enhanced by Electrostatic Precipitation (ePIPAC) for Patients with Peritoneal Metastases

“…With the palliative strategy, many authors have suggested that stable disease after oncologic treatment might confirm its efficacy and even more so in additional lines of treatment. 23,24 This palliative therapy aims to treat the peritoneal metastasis directly and to stabilize or decrease the tumor proliferation while at the same time not altering the QoL of the patients, as does standard PIPAC. 25 Although, we were limited by the number of questionnaires returned by the patients and the patients who stopped the ePIPAC therapy, the QoL was stable up to the third ePI-PAC treatment and improved significantly for the patients who could receive more than three ePIPACs.…”

Ginsenoside Rg3 Serves as an Adjuvant Chemotherapeutic Agent and VEGF Inhibitor in the Treatment of Non‐Small Cell Lung Cancer: A Meta‐Analysis and Systematic Review

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