1528P - The TYROL study SCLC project: retrospective analysis of clinical features and therapeutic outcome in 484 small cell lung cancer patients diagnosed 1...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Small-Cell Lung Cancer
Presenter Michael Fiegl
Authors M. Fiegl1, A. Pircher2, W. Sterlacci3, H. Jamnig4, T. Schmid5, M. Nevinny6, G. Pall7, W. Oberaigner8, G. Zangerl9, W. Hilbe10
  • 1Medical University Innsbruck, 6020 - Innsbruck/AT
  • 2Hematology And Oncology, Internal Medicine V, Medical University Innsbruck, 6020 - Innsbruck/AT
  • 3Department Of Pathology, Hospital of Feldkirch, 6807 - Feldkirch/AT
  • 4Pneumology, Hospital of Natters, 6161 - Natters/AT
  • 5Thoracic Surgery, Medical University of Innsbruck, 6020 - Innsbruck/AT
  • 6Radiooncology, Medical University of Innsbruck, 6020 - Innsbruck/AT
  • 7Internal Medicine I, Medical University of Innsbruck, 6020 - Innsbruck/AT
  • 8Institute Of Epidemiology Tilak, Medical University of Innsbruck, 6020 - Innsbruck/AT
  • 9Internal Medicine, Hospital of Zams, 6511 - Zams/AT
  • 10Department Of Internal Medicine, Medical University Innsbruck, 6020 - Innsbruck/AT

Abstract

Introduction

Consecutive SCLC cases treated in Innsbruck/Natters Comprehensive Cancer Center were analysed in order to achieve results in the routine setting and to depict cohorts with long term survival.

Methods

All patients with SCLC were documented with respect to disease and therapy features aiming at describing this disease and treatments applied in most possible detail.

Results

Of 484 patients, 326 (67%) were male. Extensive stage at diagnosis in 269/483 informative cases (56%), (former) smokers, 316/323 (98%); unfavorable ECOG PS (≥2), 100/303 (33%). Symptoms at initial diagnosis: hemoptysis 44/293 (15%), cough 165/299 (55%); dyspnoea 153/302 (51%); tumor pain 135/305 (44%); neurologic symptoms (incl. paraneoplasia) 69/314 (22%); hyponatremia (≤130 mmol/l)/SIADH 47/339 (14%); prior/present other malignancy 86/436 (20%). 27 patients (6%) did not receive any treatment. 26 limited disease patients were radically operated, with excellent outcome (median OS, 91 months). In the 406 evaluable patients with palliative therapy, overall response (ORR) was 56% (CR 18%, PR 39%, PD 31%, interruption 5%, death under therapy 8%); however, best response (at any time during treatment) was 78%. ORR was dramatically inferior in patients with advanced stage, unfavorable PS, and elevated LDH (p < 0.001). Median PFS from start of palliative therapy, evaluable in 415 patients, was 6.9 months. PFS was slightly superior in women (p = 0.041), and clearly inferior in patients with elevated CRP (p = 0.011) and LDH levels (p <0.001), unfavorable performance status (p = 0.001), and extensive disease (p <0.001); median OS from start of palliative therapy, evaluable in 415 patients was 11.3 months: more interestingly, there is plateau of long term survivors (5-ys survival 9.3%), mainly attributable to radiochemotherapy in limited disease (n = 118, median OS 20.3 months, 5-ys survival 22%). LDH and CRP, and PS are simple parameters significantly predictive for OS (p < 0.001). Second line palliative therapy was administered in 206 patients (ORR 23%); third line, 93 patients (ORR 14%); fourth line, 26 patients (ORR 8%) and fifth line, 9 patients (ORR 0%).

Conclusion

We are working on the establishment of diagnostic and therapeutic algorithms for an optimized management in this unfavourable disease.

Disclosure

All authors have declared no conflicts of interest.