Trends in Response Rate and Survival in Small-Cell Lung Cancer Patients Between 1997 and 2017

Abstract : Introduction: Median survival of small-cell lung cancer (SCLC) patients is usually around 1 year. The advent of new drugs may have slightly improved their prognosis. We aimed to assess whether SCLC response to chemotherapy and survival had changed over time. Methods: Consecutive SCLC patients were included at Grenoble University Hospital, France. We compared the patients’ characteristics, response to chemotherapy and survival between 1997-2009 (Period 1) and 2010-2017 (Period 2). Results: A total of 529 patients were identified, of whom 498 received a first line of chemotherapy and 279 a second line. The majority (n=290, 58%) had extensive disease. The objective response rate (ORR) to first-line chemotherapy in metastatic patients was 63% in period 1 and 62% in period 2; the ORRs to second-line chemotherapy were 39% and 29%, respectively. Median overall survival from first-line chemotherapy was 13.2 months (interquartile range [IQR]: 7.4–24.4) in period 1 and 11.2 months (IQR: 7.1–21.2) in period 2. Mortality in these two periods did not differ significantly even after adjustment for prognostic factors (hazard ratio [HR] = 0.82, 95% confidence interval [CI] 0.66–1.00). The factors independently associated with death were cardiovascular comorbidities (HR=1.28 [95%CI 1.05–1.55]), liver comorbidities (HR=1.31 [95%CI 1.03–1.65]), poor ECOG performance status (3–4 vs. 0–1, HR=2.45 [95%CI 1.83–3.30]) and extensive disease (HR=2.69 [95%CI 2.18–3.33]). Conclusions : Since 1997, there has been no improvement in the survival or response rate to chemotherapy of SCLC patients. There is a desperate need for new approaches in this setting.
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Master Thesis
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Mickaël Lattuca Truc. Trends in Response Rate and Survival in Small-Cell Lung Cancer Patients Between 1997 and 2017. Human health and pathology. 2019. ⟨dumas-02188372⟩

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