Hyponatremia and hypoalbuminemia as predictive factors for response to first line treatment for metastatic non-small cell lung cancer

Background

There is a great controversies in the choice of the best drug for first line treatment of metastatic non-small cell lung cancer (NSCLC); especially for those patients with no driving mutation. In this analysis we try to identify predictive factors which may help selection of first line therapy for metastatic NSCLC in big retrospective data.

Methods

we conducted a retrospective analysis of patients with stage IV NSCLC receiving systemic treatment at the University of Alabama at Birmingham (UAB) comprehensive cancer center which is a NCCN member institute. Pretreatment risk factors including age, race, gender, presenting symptoms, histological feature of tumor and pretreatment laboratory values, were evaluated. These factors correlated with response to fist line therapy.

Results

409 patients received more than 10 different regimens as first line treatment in metastatic non-small-cell lung cancer. The most commonly used regimens were paclitaxel and carboplatin with or without bevacizumab; Carboplatin and pemetrexed with or without bevacizumab; pemetrexed single agent; Carboplatin and Gemcitabine; or Tyrosine kinase inhibitor. Most of patients in our series had performance status range between 0-1 More than 50 pretreatment factor were analyzed of which smoking (p = 0.049), pleural metastases or effusion (p = 0.004), abdominal metastases (p = 0.033), hypoalbuminemia (p = 0.043) and hyponatremia (p = 0.002) are associated with poor responses to first line treatment of metastatic NSCLC.

Conclusions

Hypoalbuminemia, hyponatremia among other factors can help identify patients who are less likely to respond to first line therapy for treatment of metastatic NSCLC. We are finalizing mathematical model that incorporate these factors. This may help in the selection of patients for systemic therapy and may improve stratification in clinical trials.Bottom of Form

Clinical trial identification

Legal entity responsible for the study

UAB

Funding

Ministry of Higher Education; Egypt

Disclosure

All authors have declared no conflicts of interest.