Abstract 171P
Background
This study compared irinotecan/cisplatin (IP) with etoposide/cisplatin (EP) in patients with untreated extensive-stage small-cell lung cancer (ES-SCLC). The efficacy of the two regimens in 208 patients with ES-SCLC was retrospectively compared.
Methods
A total of 301 patients were diagnosed with ES-SCLC at Kyungpook National University Hospital in Daegu, Korea, from April 2001 to November 2017. Of these patients, 84 were not included in this study; So, a total of 208 patients were treated with either EP or IP regimen as first-line chemotherapy and analyzed through medical records review. The EP regimen consisted of cisplatin 60 mg/m2 on day 1 and etoposide 100 mg/m2 on day 1, 2, and 3 every 3 weeks. The IP regimen consisted of cisplatin 60 mg/m2 on day 1 and irinotecan 60 mg/m2 on day 1, 8, and 15 every 4 weeks.
Results
More patients received subsequent chemotherapy after the first-line chemotherapy in the EP group than in the IP group (P = 0.03)The response rate was statistically higher in the IP regimen than in the EP regimen (79.6% vs. 66.7%, respectively, P = 0.04).Patients treated with IP regimen showed significantly longer PFS than EP regimen (PFS for EP = 5.3 months and IP = 6.5 months, Log-Rank P = 0.02; HR = 0.71, 95% CI = 0.52–0.97, P = 0.03, table). However, the first-line chemotherapy regimens did not affect OS with adjustment age, gender, smoking status, stage, ECOG performance status, weight loss, second-line chemotherapy, and thoracic radiation therapy (median survival time [MST] for EP = 10.0 months and IP = 9.8 months, Log-Rank P = 0.72; HR = 0.86, 95% CI = 0.65–1.25, P = 0.31). There was no difference in treatment-related death between the two regimens. There were two treatment-related deaths in the EP regimen and two in the IP regimen.
Table: 171POverall survival and progression-free survival according to regimens
| Progression-free survival | Overall survival | |||||||
|---|---|---|---|---|---|---|---|---|
| Regimen | Median TTP (95% CI, month) | Log-Rank P | HR (95% CI)a | P-valuea | MST (95% CI, month) | Log-Rank P | HR (95% CI)a | P-valuea |
| EP (n = 110) | 5.3 (4.4–5.8) | 0.02 | 1.00 | 10.0 (8.1–11.7) | 0.72 | 1.00 | ||
| IP (n = 98) | 6.5 (5.6–7.0) | 0.71 (0.52–0.97) | 0.03 | 9.8 (7.9–11.5) | 0.86 (0.65–1.15) | 0.31 |
Conclusions
IP regimen together with EP regimen can be considered as the first-line treatment for ES-SCLC in the Asian population.
Legal entity responsible for the study
The authors.
Funding
National Research Foundation of Korea (NRF) funded by the Ministry of Education.
Disclosure
All authors have declared no conflicts of interest.