The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy
Abstract Background Currently, no biomarkers can accurately predict survival outcomes in patients with SCLC undergoing treatment. Tumor growth rate (TGR; percent size change per month [%/m]) is suggested as an imaging predictor of response to anti‐cancer treatment. We aimed to evaluate the predictiv...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5611 |
| _version_ | 1797838363893432320 |
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| author | Xiang Chen Xueyuan Chen Tingting Liu Ting Zhou Gang Chen Huaqiang Zhou Yan Huang Wenfeng Fang Yunpeng Yang Ningning Zhou Likun Chen Silang Mo Li Zhang Yuanyuan Zhao |
| author_facet | Xiang Chen Xueyuan Chen Tingting Liu Ting Zhou Gang Chen Huaqiang Zhou Yan Huang Wenfeng Fang Yunpeng Yang Ningning Zhou Likun Chen Silang Mo Li Zhang Yuanyuan Zhao |
| author_sort | Xiang Chen |
| collection | DOAJ |
| description | Abstract Background Currently, no biomarkers can accurately predict survival outcomes in patients with SCLC undergoing treatment. Tumor growth rate (TGR; percent size change per month [%/m]) is suggested as an imaging predictor of response to anti‐cancer treatment. We aimed to evaluate the predictive role of the maximum TGR (TGRmax) for outcomes of small‐cell lung cancer (SCLC) patients undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor (ICI) treatment. Methods Patients with SCLC receiving first‐line chemotherapy plus immunotherapy were analyzed within this retrospective study. The X‐tile program was used to identify the cut‐off value of TGRmax based on maximum progression‐free survival (PFS) stratification. The Kaplan–Meier methods and Cox regression models were used to evaluate the effect of the presence of TGRmax on PFS and overall survival (OS). Results In total, 104 patients were evaluated. Median (range) TGRmax was −33.9 (−65.2 to 21.6) %/m and the optimal cut‐off value of TGRmax was −34.3%/m. Multivariate Cox regression analysis revealed that patients with TGRmax > −34.3%/m was associated with shorter PFS (hazard ratio [HR], 2.81; 95% CI, 1.71–4.63; p < 0.001) and OS (HR, 3.17; 95% CI, 1.41–7.08; p = 0.005). In patients who received partial response (PR), Kaplan–Meier survival analyses showed that superior PFS and OS (p = 0.005 and p = 0.009, respectively) benefit was observed when TGRmax ≤−34.3%/m. Conclusions SCLC patients with TGRmax > −34.3%/m had worse PFS and OS in first‐line ICI plus platin‐based chemotherapy. TGRmax could independently serve as an early biomarker to predict the benefit from chemoimmunotherapy. |
| first_indexed | 2024-04-09T15:40:40Z |
| format | Article |
| id | doaj.art-38d96db998cc4b999c54f0ee90dc1cf9 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T15:40:40Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-38d96db998cc4b999c54f0ee90dc1cf92023-04-27T10:12:43ZengWileyCancer Medicine2045-76342023-04-011278122813310.1002/cam4.5611The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapyXiang Chen0Xueyuan Chen1Tingting Liu2Ting Zhou3Gang Chen4Huaqiang Zhou5Yan Huang6Wenfeng Fang7Yunpeng Yang8Ningning Zhou9Likun Chen10Silang Mo11Li Zhang12Yuanyuan Zhao13Medical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaMedical Oncology Department Sun Yat‐Sen University Cancer Center Guangzhou ChinaAbstract Background Currently, no biomarkers can accurately predict survival outcomes in patients with SCLC undergoing treatment. Tumor growth rate (TGR; percent size change per month [%/m]) is suggested as an imaging predictor of response to anti‐cancer treatment. We aimed to evaluate the predictive role of the maximum TGR (TGRmax) for outcomes of small‐cell lung cancer (SCLC) patients undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor (ICI) treatment. Methods Patients with SCLC receiving first‐line chemotherapy plus immunotherapy were analyzed within this retrospective study. The X‐tile program was used to identify the cut‐off value of TGRmax based on maximum progression‐free survival (PFS) stratification. The Kaplan–Meier methods and Cox regression models were used to evaluate the effect of the presence of TGRmax on PFS and overall survival (OS). Results In total, 104 patients were evaluated. Median (range) TGRmax was −33.9 (−65.2 to 21.6) %/m and the optimal cut‐off value of TGRmax was −34.3%/m. Multivariate Cox regression analysis revealed that patients with TGRmax > −34.3%/m was associated with shorter PFS (hazard ratio [HR], 2.81; 95% CI, 1.71–4.63; p < 0.001) and OS (HR, 3.17; 95% CI, 1.41–7.08; p = 0.005). In patients who received partial response (PR), Kaplan–Meier survival analyses showed that superior PFS and OS (p = 0.005 and p = 0.009, respectively) benefit was observed when TGRmax ≤−34.3%/m. Conclusions SCLC patients with TGRmax > −34.3%/m had worse PFS and OS in first‐line ICI plus platin‐based chemotherapy. TGRmax could independently serve as an early biomarker to predict the benefit from chemoimmunotherapy.https://doi.org/10.1002/cam4.5611chemoimmunotherapyfirst‐line treatmentSCLCsmall cell lung cancersurvivaltumor growth rate |
| spellingShingle | Xiang Chen Xueyuan Chen Tingting Liu Ting Zhou Gang Chen Huaqiang Zhou Yan Huang Wenfeng Fang Yunpeng Yang Ningning Zhou Likun Chen Silang Mo Li Zhang Yuanyuan Zhao The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy Cancer Medicine chemoimmunotherapy first‐line treatment SCLC small cell lung cancer survival tumor growth rate |
| title | The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy |
| title_full | The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy |
| title_fullStr | The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy |
| title_full_unstemmed | The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy |
| title_short | The maximum tumor growth rate predicts clinical outcomes of patients with small‐cell lung cancer undergoing first‐line chemotherapy plus immune‐checkpoint inhibitor therapy |
| title_sort | maximum tumor growth rate predicts clinical outcomes of patients with small cell lung cancer undergoing first line chemotherapy plus immune checkpoint inhibitor therapy |
| topic | chemoimmunotherapy first‐line treatment SCLC small cell lung cancer survival tumor growth rate |
| url | https://doi.org/10.1002/cam4.5611 |
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