Abstract 69P
Background
Chemotherapy-induced neutropenia (CIN) is a dose-limiting toxicity of many chemotherapy agents. Recently, CIN has been associated with longer survival time in various types of cancer, suggesting a role as a prognostic factor. However, no large-scale study has yet investigated the utility of CIN as a prognostic factor in small cell lung cancer. We therefore conducted this multicenter retrospective observational study to investigate the utility of CIN as a prognostic factor for overall survival (OS) in patients with extensive-disease small-cell lung cancer (ED-SCLC) treated with chemotherapy.
Methods
Clinical data, including data on CIN onset during chemotherapy, were collected from electronic medical records of patients with ED-SCLC who received standard-dose irinotecan and cisplatin (IP regimen) as primary therapy at 14 participating institutions across Japan between January 1, 2012 and December 31, 2016. Landmark analysis, with the association between OS and neutropenia as the primary endpoint was performed with 102 patients who completed all four cycles of the IP regimen and whose OS was ≥112 days. Univariate analysis using the log-rank test and multivariate analysis using the Cox proportional hazards model with factors previously identified as possible prognostic factors as covariates were also performed to examine the association between CIN and OS.
Results
Analysis of median OS by grade among patients who developed CIN revealed significantly longer survival in the group with grade 4 CIN (633 days, 95% confidence interval [CI]: 379–757) than in the group with grade 0 to 3 CIN (444 days, 95% CI: 360–505) (P = 0.0279). Multivariate analysis suggested that lactate dehydrogenase (LDH) of ≥ 230 IU/L (hazard ratio [HR]: 2.937; 95% CI: 1.739–4.958, P < 0.001) and grade 0 to 3 CIN (HR: 2.096; 95% CI: 1.151–3.818, P = 0.0156) are independent poor prognostic factors for ED-SCLC.
Conclusions
Onset of grade 4 CIN was associated with longer OS in patients with ED-SCLC. Our results also show that both LDH and CIN may be prognostic factors in patients treated using the IP regimen.
Clinical trial identification
This study was approved by the Institutional Review Board of our institution (approval no: T29-8-30-2-3).
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
329P - High-level expression of HDAC10 is associated with PD-L1 expression and poor prognosis in patients with non-small cell lung cancer receiving pulmonectomy
Presenter: Xiaomei Liu
Session: Poster display session
Resources:
Abstract
331P - A retrospective analysis of immune checkpoint therapy in patients with non-small cell lung cancer: Focus on thyroid disorder
Presenter: Sawana Ono
Session: Poster display session
Resources:
Abstract
332P - Analyse the association between adverse events (AEs) and survival in patients treated with immune checkpoint inhibitors (ICIs)
Presenter: Chi-yuan Cheng
Session: Poster display session
Resources:
Abstract
333P - Study of searching on efficacy of immune checkpoint inhibitor for the non-small cell lung cancer using FDG-PET/CT and thallium SPECT
Presenter: KAYOKO Kibata
Session: Poster display session
Resources:
Abstract
334P - Incidence and characteristic of adrenal insufficiency due to immune checkpoint inhibitors therapy
Presenter: Daisuke Etoh
Session: Poster display session
Resources:
Abstract
335P - PD-L1 profile of nasopharyngeal cancer patients in Indonesia
Presenter: Handoko Handoko
Session: Poster display session
Resources:
Abstract
336P - Pembrolizumab plus chemotherapy versus pembrolizumab monotherapy for PD-L1-positive advanced non-small cell lung cancer in the real world
Presenter: Jun Sugisaka
Session: Poster display session
Resources:
Abstract
337P - Neutrophil-to-Lymphocyte ratio as a predictive factor for hyperprogressive disease in NSCLC patients treated with immune checkpoint inhibitor
Presenter: Ryo Takahashi
Session: Poster display session
Resources:
Abstract
338P - A new insight into tumour immune-evasion: Crosstalk between cancer stem cells and T regulatory cells
Presenter: Abhishek Dutta
Session: Poster display session
Resources:
Abstract
339TiP - PACIFIC-5: Phase III study of durvalumab after either concurrent or sequential chemoradiotherapy (CRT) in patients with stage III NSCLC
Presenter: Yi-Long Wu
Session: Poster display session
Resources:
Abstract