94P - First-line treatment with cisplatin plus etoposide for small cell lung cancer and large cell neuroendocrine carcinoma: Our center experience

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Cytotoxic agents
Small-Cell Lung Cancer
Neuroendocrine Cancers
Therapy
Biological therapy
Presenter Gabriella Del Bene
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors G. Del Bene1, A. Prelaj1, J.R. Giron Berrios1, L. De Filippis1, A. Emiliani1, A. Galletti1, C. Ferrara2, F. Longo1
  • 1Medical Oncology Unit A, Sapienza University Of Rome Italy, Policlinico Umberto I Sapienza University of Rome, 00166 - Rome/IT
  • 2Department Of Public Health And Infectious Diseases, Sapienza University of Rome, 00185 - Rome/IT

Abstract

Background

Large Cell Neuroendocrine Carcinoma (LCNEC) and Small Cell Lung Cancer (SCLC) account for about 3% and 12% of all pulmonary malignancies, respectively. Both share several histological features and are characterized by common clinical aspects including aggressive clinical courses. Because of the rarity of this disease, the optimal management approach has not yet been determined and it remains uncertain whether patients diagnosed with LCNEC should be treated according to NSCLC-based or SCLC-based regimes. Rossi et al. showed that for LCNEC, SCLC-based chemotherapy was an important variable significantly correlating with survival in metastatic settings. A retrospective review of 45 patients with advanced LCNEC assessed that the progression free survival (PFS) was 6.1 and 4.9 months (p = 0.41) and the overall survival (OS) was 16.5 and 9.2 months (p = 0.10) depending on whether first-line chemotherapy used regimens designed for SCLC or for NSLC. Our aim is to report our experience in the treatment of high grade neuroendocrine carcinoma.

Methods

A total of 76 patients from 2005 to 2015 with high-grade neuroendocrine carcinoma of the lung with advanced stage or metastatic disease were enrolled: 46 SCLC (60.5%), 30 LCNEC (39.5%). The Kaplan–Meier test was used to evaluate the PFS and OS for SCLC and LCNEC. All patients received a combination of cisplatin 75 mg/m2 d 1q21 and etoposide 100 mg/m2 on d 1–3q21, with or without sequential thoracic radiotherapy.

Results

67 patients (88.2%) had a smoking history, 65.8% men, 34.2% women; median age was 64 years (range 40–80). Patients received a median of 6 cycles (range 3–6). The median PFS was 6.2 months (95% Confidence Interval, CI 4.0–8.3) for SCLC and 7.5 months (95% CI 4.5–10.3) for LCNEC. The OS was 14.6 months (95% CI 7.6–21.6) for SCLC and 10.5 months (95% CI 8.0–13.0) for LCNEC.

Conclusions

Our analysis shows the clear preponderance in the male gender and an important association with a smoking history. Results show also that LCNEC patients treated with cisplatin-etoposide have similar PFS and OS than SCLC patients. In addition, radiotherapy seems to improve outcomes probably due to a better local control.

Clinical trial identification

Legal entity responsible for the study

Policlinico Umberto I

Funding

Policlinico Umberto I

Disclosure

All authors have declared no conflicts of interest.