Curative efficacy might be an early predictor of prognosis in patients with small cell lung cancer treated with 2 cycles of platinum-based first-line chemotherapy

Kaibo Zhu; Minlin Jiang; Yi Xu; Peixin Chen; Hao Wang; Jia Yu; Jun Zhu; Wencheng Zhao; Die Meng; Yayi He

doi:10.21037/jtd-21-216

Curative efficacy might be an early predictor of prognosis in patients with small cell lung cancer treated with 2 cycles of platinum-based first-line chemotherapy

J Thorac Dis. 2021 Feb;13(2):1205-1214. doi: 10.21037/jtd-21-216.

Authors

Kaibo Zhu¹, Minlin Jiang^{2

3}, Yi Xu^{2

3}, Peixin Chen^{2

3}, Hao Wang^{2

3}, Jia Yu^{2

3}, Jun Zhu^{2

3}, Wencheng Zhao^{2

3}, Die Meng^{2

3}, Yayi He¹

Affiliations

¹ Department of Hematology, Xiangtan Central Hospital, Xiangtan, China.
² Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, China.
³ Tongji University, Shanghai, China.

Abstract

Background: Platinum-based chemotherapy remains the essential therapy for small cell lung cancer (SCLC). Here, we conducted a statistical analysis to explore whether the curative efficacy of 2-cycle platinum-based chemotherapy can predict the survival of patients with SCLC.

Methods: Fifty-six SCLC patients who had each received 2 cycles of platinum-based chemotherapy were enrolled. The curative efficacy of the chemotherapy was evaluated, mainly by chest computed tomography, and the treatment response was categorized according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Patients were continuously followed up for progression-free survival (PFS) and overall survival. The 55 patients were separated into 2 groups by the curative efficacy of the 2-cycle first-line platinum-based chemotherapy. All statistical analyses were performed with SPSS software (version 17.0; SPSS, Inc.; Chicago, IL, USA).

Results: Patients who responded to 2-cycle chemotherapy (partial response, PR) had significantly better survival than others who did not (stable disease, SD or progressive disease, PD). The median progression-free survival (mPFS) in the PR group was 6.330 months, which was significantly longer than the 2.870 months seen in SD+PD group (95% CI: 4.631-8.029 vs. 0.000-5.790, P=0.022). The median overall survival (mOS) was 10.870 months in the PR group, which was remarkably longer than the 8.970 months observed in the SD+PD group (95% CI: 9.546-12.194 vs. 6.517-11.423, P=0.028). Curative efficacy had no correlation with clinical features.

Conclusions: The curative efficacy of 2-cycle first-line platinum-based chemotherapy was significantly correlated with PFS and OS, and showed prognostic value in SCLC patients. Patients who were sensitive to chemotherapy had superior survival to those who were chemotherapy insensitive.

Keywords: Small cell lung cancer (SCLC); chemotherapy; survival analysis.