1540 - Comparison of second line treatment outcomes between sensitive and refractory small cell lung cancer patients: a retrospective analysis

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Cytotoxic agents
Small-Cell Lung Cancer
Therapy
Biological therapy
Presenter Taner Korkmaz
Authors T. Korkmaz1, S. Seber2, E. Sari2, M. Canhoroz3, B. Oven Ustaalioglu4, U. Kefeli4, O. Balvan4, M. Gumus5, N. Yasar4, S.N. Turhal6
  • 1Medical Oncology, Dr lutfi kirdar kartal research and educational hospital, 34600 - istanbul/TR
  • 2Medical Oncology Department, marmara university hospital, 34660 - istanbul/TR
  • 3Medical Oncology Department, uludag university hospital, 23456 - bursa/TR
  • 4Medical Oncology Department, Dr lutfi kirdar kartal research and educational hospital, 34600 - istanbul/TR
  • 5Dept. Medical Oncology, Kartal Research and Training HospitalDivision of Medical Oncology, TR-81470 - Istanbul/TR
  • 6Medical Oncology, Marmara University Hospital, TR-34600 - Istanbul/TR

Abstract

Introduction

Small cell lung cancer (SCLC) has a high relaps rate despite being very chemosensitive. The prognosis of these patients is generally poor. The efficasy of second line treatment is dismal when compared to other chemosensitive tumors such as germ cell tumor or lymphoma. Our aim was to evaluate the outcome of second line treatment and to delineate the prognostic factors that would effect the survival times and response rates.

Methods

Results we retrospectively assesed 120 SCLC patients who who failed firstline platinum-etoposide chemotherapy and went on to receive second line chemotherapy at 3 medical oncology centers.

Results

Median age of the study group was 58 (33-78) and %80 percent of our patients were below 65 years old. %84 patient were male, %82 had an ECOG PS of 0-1. %61 were at extensive stage at the time of diagnosis. Patients who progressed more than 3 months after first line therapy were labelled as platin sensitive (%64). The patients who received platin based combination based treatment was % 27. Median PFS and OS starting from the initiation of second line treatment were 4 and 7 months respectively. Multivariate analysis identified PS (P= 0.006), extent od disease at inital stage(0.014) and platin sensitivity (0.001) as the independent prognostic factors for survival. Subgroup analyses of the platin sensitive patients indicated platin re challenge yields higher PFS, OS and RR . There was no difference was found between irinotecan and topotecan in the refractory patient group in terms of treatment outcomes.

Conclusion

Patients with good PS, who are platin sensitive or initially staged as limited disease derive the most benefit from second line chemotherapy in the setting of relapsed SCLC. Platin combination therapy should be the treatment of choice in the platin sensitive patients.

Disclosure

All authors have declared no conflicts of interest.