Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes
In this observational study, we assessed treatment patterns and prognostic factors in patients with small cell lung cancer (SCLC) in a large state-mandated healthcare organization in Israel. <i>Methods:</i> All incident cases with histologically confirmed SCLC who initiated systemic anti...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/1/36 |
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| author | Sarah Sharman Moser Jair Bar Inna Kan Keren Ofek Raanan Cohen Nikhil Khandelwal Varda Shalev Gabriel Chodick Nava Siegelmann-Danieli |
| author_facet | Sarah Sharman Moser Jair Bar Inna Kan Keren Ofek Raanan Cohen Nikhil Khandelwal Varda Shalev Gabriel Chodick Nava Siegelmann-Danieli |
| author_sort | Sarah Sharman Moser |
| collection | DOAJ |
| description | In this observational study, we assessed treatment patterns and prognostic factors in patients with small cell lung cancer (SCLC) in a large state-mandated healthcare organization in Israel. <i>Methods:</i> All incident cases with histologically confirmed SCLC who initiated systemic anti-cancer treatment between 2011 and 2017 were identified. Treatment patterns and overall survival (OS) were evaluated for each line of therapy. <i>Results:</i> A total of 235 patients were identified (61% male, median age 64 years, 95% ever smokers, 64% had extensive stage). The first-line treatment was platinum–etoposide regimen for 98.7% of the cohort. The second and third-line regimen were given to 43% and 12% of patients, respectively. Mean OS for extensive and limited stage patients was 9.1 and 23.5 months respectively. In a multivariable model, increased risk for mortality was observed among patients with an ECOG performance status (PS) of 2 compared to a PS of 0–1 for the extensive stage patients (Hazard ratio (HR) = 1.63, 95% confidence ratios (CI): 1.00–2.65); and for males compared to females for the limited stage patients (HR = 2.17; 95% CI: 1.12–4.20). Regarding all 2nd line patients in a multivariable model incorporating relevant confounding factors, demonstrated a significantly better outcome with platinum–based regimens compared to topotecan. Median survival after initiation of 2nd line in platinum-sensitive patients was longer (<i>p</i> = 0.056) for those re-challenged with platinum–based regimen (n = 7): 6.8mo (6.1-not reported (NR)), compared with those switched to a different treatment (n = 27): 4.5 mo (2.6–6.6) for extensive stage patients, and a non-significant difference was also observed for limited stage patients. <i>Conclusion:</i> To our knowledge, this is one of the largest real-world studies of SCLC patients. OS for SCLC patients was similar to that reported in clinical trials. PS for extensive stage patients and sex for limited stage patients were significant correlates of prognosis. Re-challenge of the platinum–based doublet was associated with longer OS compared to switching treatment in extensive stage patients. |
| first_indexed | 2024-03-10T08:01:24Z |
| format | Article |
| id | doaj.art-cc0d8032e94843db9d6a1ded6f2daf95 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T08:01:24Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-cc0d8032e94843db9d6a1ded6f2daf952023-11-22T11:28:46ZengMDPI AGCurrent Oncology1198-00521718-77292021-01-0128131733110.3390/curroncol28010036Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment OutcomesSarah Sharman Moser0Jair Bar1Inna Kan2Keren Ofek3Raanan Cohen4Nikhil Khandelwal5Varda Shalev6Gabriel Chodick7Nava Siegelmann-Danieli8Maccabitech, Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv 6812509, IsraelSheba Medical Center, Institute of Oncology, Tel Hashomer, Ramat Gan 5262000, IsraelAbbvie Biopharmaceuticals Ltd., Hod Hasharon 4524075, IsraelAbbvie Biopharmaceuticals Ltd., Hod Hasharon 4524075, IsraelAbbvie Biopharmaceuticals Ltd., Hod Hasharon 4524075, IsraelAbbvie Inc., Chicago, IL 60064, USAMaccabitech, Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv 6812509, IsraelMaccabitech, Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv 6812509, IsraelMaccabitech, Maccabi Institute for Research & Innovation, Maccabi Healthcare Services, Tel Aviv 6812509, IsraelIn this observational study, we assessed treatment patterns and prognostic factors in patients with small cell lung cancer (SCLC) in a large state-mandated healthcare organization in Israel. <i>Methods:</i> All incident cases with histologically confirmed SCLC who initiated systemic anti-cancer treatment between 2011 and 2017 were identified. Treatment patterns and overall survival (OS) were evaluated for each line of therapy. <i>Results:</i> A total of 235 patients were identified (61% male, median age 64 years, 95% ever smokers, 64% had extensive stage). The first-line treatment was platinum–etoposide regimen for 98.7% of the cohort. The second and third-line regimen were given to 43% and 12% of patients, respectively. Mean OS for extensive and limited stage patients was 9.1 and 23.5 months respectively. In a multivariable model, increased risk for mortality was observed among patients with an ECOG performance status (PS) of 2 compared to a PS of 0–1 for the extensive stage patients (Hazard ratio (HR) = 1.63, 95% confidence ratios (CI): 1.00–2.65); and for males compared to females for the limited stage patients (HR = 2.17; 95% CI: 1.12–4.20). Regarding all 2nd line patients in a multivariable model incorporating relevant confounding factors, demonstrated a significantly better outcome with platinum–based regimens compared to topotecan. Median survival after initiation of 2nd line in platinum-sensitive patients was longer (<i>p</i> = 0.056) for those re-challenged with platinum–based regimen (n = 7): 6.8mo (6.1-not reported (NR)), compared with those switched to a different treatment (n = 27): 4.5 mo (2.6–6.6) for extensive stage patients, and a non-significant difference was also observed for limited stage patients. <i>Conclusion:</i> To our knowledge, this is one of the largest real-world studies of SCLC patients. OS for SCLC patients was similar to that reported in clinical trials. PS for extensive stage patients and sex for limited stage patients were significant correlates of prognosis. Re-challenge of the platinum–based doublet was associated with longer OS compared to switching treatment in extensive stage patients.https://www.mdpi.com/1718-7729/28/1/36SCLCsurvivalobservational studyplatinum sensitivelimited stage |
| spellingShingle | Sarah Sharman Moser Jair Bar Inna Kan Keren Ofek Raanan Cohen Nikhil Khandelwal Varda Shalev Gabriel Chodick Nava Siegelmann-Danieli Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes Current Oncology SCLC survival observational study platinum sensitive limited stage |
| title | Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes |
| title_full | Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes |
| title_fullStr | Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes |
| title_full_unstemmed | Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes |
| title_short | Real World Analysis of Small Cell Lung Cancer Patients: Prognostic Factors and Treatment Outcomes |
| title_sort | real world analysis of small cell lung cancer patients prognostic factors and treatment outcomes |
| topic | SCLC survival observational study platinum sensitive limited stage |
| url | https://www.mdpi.com/1718-7729/28/1/36 |
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