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Tufman A, Schneiderbauer S, Walter J, Resuli B, Kauffmann-Guerrero D, Mümmler C, Mertsch P, Götschke J, Kovács J, Manapov F, Schneider C, Sellmer L, Arnold P, Heinemann V, Behr J, Nasseh D. Early mortality in German patients with lung cancer: risk factors associated with 30-and 60-day mortality. Clin Exp Med 2023; 23:5183-5190. [PMID: 37700112 PMCID: PMC10725334 DOI: 10.1007/s10238-023-01187-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
Despite therapeutic advances, early mortality in lung cancer is still prevalent. In this study, we aimed to assess risk factors for 30- and 60-day mortality in German lung cancer patients. In this retrospective cross-sectional analysis, we used data of lung cancer patients treated at LMU Hospital Munich between 2015 and 2019. We categorized patients into 30-day mortality, 60 day-mortality, and longer survival. We used Student's t-test and ANOVA to compare means and Chi2-test to compare frequencies. We used logistic regression analysis to identify factors associated with a risk for early mortality. Of the 2454 lung cancer patients, 2.0% (n = 50) died within 30 and 1.7% (n = 41) within 30 to 60 days of diagnosis. Older age and advanced stage at diagnosis were significantly associated with early mortality in the univariate and the multivariate analysis. Patients in the 30-day mortality group significantly more often did not receive tumor-directed therapy. They were also more likely to die in an acute care setting compared to the 60-day mortality group. The group of patients who died unexpectedly (12.0%) was dominantly female, with a high proportion of patients with unintentional weight loss at the time of diagnosis. Our results suggest that in the treatment of patients with lung cancer there is a need for a greater focus on older patients. Moreover, physicians should pay special attention to females with recent weight loss and patients with a comorbidity of diabetes mellitus or renal impairment. Engaging a case manager focused on detecting patients with the above characteristics could help improve overall care.
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Affiliation(s)
- Amanda Tufman
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | | | - Julia Walter
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany.
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany.
| | - Blerina Resuli
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Diego Kauffmann-Guerrero
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Carlo Mümmler
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Pontus Mertsch
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Jeremias Götschke
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
| | - Julia Kovács
- Department of Thoracic Surgery Munich, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Farkhad Manapov
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Christian Schneider
- Department of Thoracic Surgery Munich, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Laura Sellmer
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Paola Arnold
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Volker Heinemann
- Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
| | - Jürgen Behr
- Department of Medicine V, University Hospital, LMU Munich, Munich, Germany
- German Center for Lung Research (DZL), Aulweg 130, 35392, Gießen, Germany
| | - Daniel Nasseh
- Comprehensive Cancer Center, University Hospital, LMU Munich, Munich, Germany
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Li Z, Pang M, Liang X, Zhang Y, Zhang W, He W, Sheng L, An Y. Risk factors of early mortality in patients with small cell lung cancer: a retrospective study in the SEER database. J Cancer Res Clin Oncol 2023; 149:11193-11205. [PMID: 37354224 DOI: 10.1007/s00432-023-05003-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Small cell lung cancer (SCLC) is a highly aggressive neuroendocrine cancer with a high risk of early mortality (i.e., survival time less than 1 month). This study aimed to identify relevant risk factors and predict early mortality in SCLC patients. METHODS A total of 27,163 SCLC cases registered between 2010 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) data. Significant independent risk factors were identified by univariate and multivariate logistic regression analyses. Nomograms for all-causes and cancer-specific early death were constructed and evaluated. RESULTS Age, sex, clinical stage, presence of metastasis (liver and lung), and absence of treatment (surgery, radiotherapy and chemotherapy) were identified for significant association with all-causes and cancer-specific early death. Nomograms based on these predictors exhibited high accuracy (area under ROC curve > 0.850) and potential clinical practicality in the prediction of early mortality. CONCLUSION We identified a set of factors associated with early mortality from SCLC and developed a clinically useful nomogram to predict high-risk patients. This nomogram could aid oncologists in the administration of individualized treatment regimens, potentially improving clinical outcomes of SCLC patients.
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Affiliation(s)
- Zhenglin Li
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Min Pang
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Xuefeng Liang
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Yafei Zhang
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Weihua Zhang
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Weina He
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China
| | - Lijun Sheng
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China.
| | - Yuji An
- The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan, China.
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Poly(ADP-Ribose) Polymerase Inhibition in Small Cell Lung Cancer: A Review. Cancer J 2021; 27:476-481. [PMID: 34904810 DOI: 10.1097/ppo.0000000000000555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Small cell lung cancer (SCLC) is a highly aggressive neuroendocrine malignancy with high and rapid relapse rates and poor outcomes. Treatment for SCLC has historically been limited by the lack of targetable driver genomic lesions, however recent developments in the underpinnings of genomic instability in SCLC and understanding of its transcriptional subtypes have led to increased interest in the use of poly(ADP-ribose) polymerase (PARP) inhibitors as a rationale therapy. Poly(ADP-ribose) polymerase inhibitors, historically designed to target BRCA1/2-mutated malignancies, capitalize on synthetic lethality in homologous recombination-deficient tumors. In this review, we outline the mechanistic rationale for the use of PARP inhibitors in treating SCLC and detail key clinical trials investigating their use in combination with chemotherapy and immunotherapy. We describe developments in the understanding of biomarkers for sensitivity to therapy and highlight further investigational directions for the use of PARP inhibitors in treating SCLC.
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Trends and variations in the treatment of stage I-III small cell lung cancer from 2008 to 2019: A nationwide population-based study from the Netherlands. Lung Cancer 2021; 162:61-70. [PMID: 34739855 DOI: 10.1016/j.lungcan.2021.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/15/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Recent treatment patterns for small cell lung cancer (SCLC) in the Netherlands were unknown. This nationwide population-based study describes trends and variations in the treatment of stage I-III SCLC in the Netherlands over the period 2008-2019. MATERIALS AND METHODS Patients were selected from the population-based Netherlands Cancer Registry. Treatments were studied stratified for clinical stage. In stage II-III, factors associated with the use of concurrent (cCRT) versus sequential chemoradiation (sCRT) and accelerated versus conventionally fractionated radiotherapy in the context of cCRT were identified. RESULTS In stage I (N = 535), 29% of the patients underwent surgery in 2008-2009 which increased to 44% in 2018-2019. Combined use of chemotherapy and radiotherapy decreased in stage I from 47% to 15%, remained constant (64%) in stage II (N = 472), and increased from 57% (2008) to 70% (2019) in stage III (N = 5,571). Use of cCRT versus sCRT in stage II-III increased over time (odds ratio (OR) 2008-2011 vs 2016-2019: 0.53 (95%-confidence interval (95%CI): 0.41-0.69)) and was strongly associated with lower age, WHO performance status 0, and diagnosis in a hospital with in-house radiotherapy. Forty-six percent of patients with stage III received cCRT in 2019. Until 2012, concurrent radiotherapy was mainly conventionally fractionated, thereafter a hyperfractionated accelerated scheme was administered more frequently (57%). Accelerated radiotherapy was strongly associated with geographic region (ORsouth vs north: 4.13 (95%CI: 3.00-5.70)), WHO performance (OR1 vs 0: 0.50 (95%CI: 0.35-0.71)), and radiotherapy facilities treating ≥ 16 vs < 16 SCLC patients annually (OR: 3.01 (95%CI: 2.38-3.79)). CONCLUSIONS The use of surgery increased in stage I. In stages II and III, the use of cCRT versus sCRT increased over time, and since 2012 most radiotherapy in cCRT was accelerated. Treatment regimens and radiotherapy fractionation schemes varied between patient groups, regions and hospitals. Possible unwarranted treatment variation should be countered.
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Goussault H, Gendarme S, Assié JB, Bylicki O, Chouaïd C. Factors associated with early lung cancer mortality: a systematic review. Expert Rev Anticancer Ther 2021; 21:1125-1133. [PMID: 34121578 DOI: 10.1080/14737140.2021.1941888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Despite recent therapeutic advances, lung cancer remains the primary cause of cancer deaths worldwide, and early lung mortality was poorly studied.Area covered: Early lung-cancer mortality reflects local therapy (surgery or radiotherapy) impact (localized forms), and metastatic disease evolution, comorbidities and healthcare-system accessibility. The definition of early lung cancer mortality is not consensual; thresholds range from 1 to 12 months post-diagnosis. This systematic review was undertaken to identify and analyze factors significantly associated with early lung cancer mortality. Age, male sex, non-adenocarcinoma histology, advanced stage at diagnosis and ECOG performance status are the main clinical factors of early lung cancer mortality. Active/ex-smoking also seems to favor early mortality, despite heterogeneous definitions of smoker status. For radio-chemotherapy treated locally advance disease, the early mortality rate increases according to tumor volume. Less well studied, socioeconomic characteristics (rurality and social deprivation index) yielded contradictory results, partially because definitions vary over studies. However, early lung cancer mortality is significantly higher for lower socioeconomic class patients.Expert opinion: Prospective, observational, general population studies are needed to better evaluate early lung-cancer mortality. International consensus concerning the patient-, disease- or healthcare system-linked factors of interest to be collected would facilitate comparisons among countries.
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Affiliation(s)
- Helene Goussault
- Respiratory Medicine, Centre Hospitalier Intercommunal De Créteil, Creteil, France.,INSERM U955, Creteil, Île-de-france, France
| | - Sebastien Gendarme
- Respiratory Medicine, Centre Hospitalier Intercommunal De Créteil, Creteil, France.,INSERM U955, Creteil, Île-de-france, France
| | - Jean Baptiste Assié
- Respiratory Medicine, Centre Hospitalier Intercommunal De Créteil, Creteil, France.,Centre De Recherche Des Cordeliers, Paris, Île-de-france, France
| | - Olivier Bylicki
- Hopital D'instruction Des Armées De Saint-Anne, Toulon, France
| | - Christos Chouaïd
- Respiratory Medicine, Centre Hospitalier Intercommunal De Créteil, Creteil, France.,INSERM U955, Creteil, Île-de-france, France
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Byers LA, Bentsion D, Gans S, Penkov K, Son C, Sibille A, Owonikoko TK, Groen HJM, Gay CM, Fujimoto J, de Groot P, Dunbar M, Kang K, He L, Sehgal V, Glasgow J, Bach BA, Ellis PM. Veliparib in Combination with Carboplatin and Etoposide in Patients with Treatment-Naïve Extensive-Stage Small Cell Lung Cancer: A Phase 2 Randomized Study. Clin Cancer Res 2021; 27:3884-3895. [PMID: 33947690 DOI: 10.1158/1078-0432.ccr-20-4259] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This study investigated the efficacy and safety of oral PARP inhibitor veliparib, plus carboplatin and etoposide in patients with treatment-naïve, extensive-stage small cell lung cancer (ED-SCLC). PATIENTS AND METHODS Patients were randomized 1:1:1 to veliparib [240 mg twice daily (BID) for 14 days] plus chemotherapy followed by veliparib maintenance (400 mg BID; veliparib throughout), veliparib plus chemotherapy followed by placebo (veliparib combination only), or placebo plus chemotherapy followed by placebo (control). Patients received 4-6 cycles of combination therapy, then maintenance until unacceptable toxicity/progression. The primary endpoint was progression-free survival (PFS) with veliparib throughout versus control. RESULTS Overall (N = 181), PFS was improved with veliparib throughout versus control [hazard ratio (HR), 0.67; 80% confidence interval (CI), 0.50-0.88; P = 0.059]; median PFS was 5.8 and 5.6 months, respectively. There was a trend toward improved PFS with veliparib throughout versus control in SLFN11-positive patients (HR, 0.6; 80% CI, 0.36-0.97). Median overall survival (OS) was 10.1 versus 12.4 months in the veliparib throughout and control arms, respectively (HR, 1.43; 80% CI, 1.09-1.88). Grade 3/4 adverse events were experienced by 82%, 88%, and 68% of patients in the veliparib throughout, veliparib combination-only and control arms, most commonly hematologic. CONCLUSIONS Veliparib plus platinum chemotherapy followed by veliparib maintenance demonstrated improved PFS as first-line treatment for ED-SCLC with an acceptable safety profile, but there was no corresponding benefit in OS. Further investigation is warranted to define the role of biomarkers in this setting.
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Affiliation(s)
| | - Dmitry Bentsion
- Sverdlovsk Regional Oncology Center, Yekaterinburg, Russian Federation
| | - Steven Gans
- Respiratory Diseases, Hospital Saint Jansdal, Harderwijk, the Netherlands
| | - Konstantin Penkov
- Private Medical Institution Euromedservice, St. Petersburg, Russian Federation
| | - ChoonHee Son
- Department of Pulmonology, Dong-A University, Busan, Korea
| | | | - Taofeek K Owonikoko
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Harry J M Groen
- Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Carl M Gay
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Junya Fujimoto
- The University of Texas MD Anderson Cancer Center, Houston, Texas.,Nagasaki University, Nagasaki, Japan
| | | | | | | | - Lei He
- AbbVie Inc., North Chicago, Illinois
| | | | | | | | - Peter M Ellis
- Juravinski Cancer Center, McMaster University, Hamilton, Ontario, Canada
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Lin J, Gautam S, Hu N, Adeboyeje G, Kachroo S. Clinical effectiveness outcomes and healthcare resource utilization of patients diagnosed with small-cell lung cancer. Future Oncol 2020; 17:443-453. [PMID: 33300811 DOI: 10.2217/fon-2020-0958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Real-world data are lacking on patients with small-cell lung cancer (SCLC) with extensive-stage SCLC (eSCLC) and poor performance status (PS). Patients & methods: Eligible patients diagnosed with eSCLC between 1 January 2008 and 31 December 2017 were included in this retrospective, observational study. Results: The study included 406 patients, with 14.3% impaired PS. Progression-free survival and overall survival were not significantly different between impaired (Eastern Cooperative Oncology Group ≥2) and not impaired patients (median, 4.5 vs 5.3 months, and 7.2 vs 8.4 months, respectively). Impaired patients used more supportive care drugs (mean, 3.0 vs 2.0; p = 0.033). Conclusion: Effectiveness outcomes among patients with and without impaired PS did not differ in the real-world setting. Progression-free survival and overall survival were similar to data from clinical trials.
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Affiliation(s)
- Junji Lin
- ConcertAI 6555 Quince, Suite 400, Memphis, TN 38119, USA
| | - Santosh Gautam
- ConcertAI 6555 Quince, Suite 400, Memphis, TN 38119, USA
| | - Nan Hu
- ConcertAI 6555 Quince, Suite 400, Memphis, TN 38119, USA
| | - Gboyega Adeboyeje
- Merck & Co., Inc. 2000 Galloping Hill Rd., Kenilworth, NJ 07033, USA
| | - Sumesh Kachroo
- Merck & Co., Inc. 2000 Galloping Hill Rd., Kenilworth, NJ 07033, USA
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Church M, Carter L, Blackhall F. Liquid Biopsy in Small Cell Lung Cancer-A Route to Improved Clinical Care? Cells 2020; 9:E2586. [PMID: 33287165 PMCID: PMC7761700 DOI: 10.3390/cells9122586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 01/22/2023] Open
Abstract
Small cell lung cancer (SCLC) has a particularly poor prognosis despite the high initial response to first-line systemic therapy, and there is a well-recognised lack of meaningful treatments beyond the second line. A number of reasons have been put forward to explain this, including a lack of common, easily-druggable genetic mutations in SCLC and rarity of high-quality tissue samples due to late presentation. Liquid biopsies, including circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA) are increasingly used as surrogates for tumour tissue and have the advantage of being easily obtained serially to inform on the biology of disease progression and acquired chemoresistance, and may provide a pathway to improve care in this notoriously refractory disease. Here we discuss the current evidence behind these liquid biopsy methods in SCLC, and how they could be employed in future clinical care.
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Affiliation(s)
- Matt Church
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (M.C.); (L.C.)
| | - Louise Carter
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (M.C.); (L.C.)
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
| | - Fiona Blackhall
- Division of Cancer Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, UK; (M.C.); (L.C.)
- The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
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Tendler S, Zhan Y, Pettersson A, Lewensohn R, Viktorsson K, Fang F, De Petris L. Treatment patterns and survival outcomes for small-cell lung cancer patients - a Swedish single center cohort study. Acta Oncol 2020; 59:388-394. [PMID: 31910696 DOI: 10.1080/0284186x.2019.1711165] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: This real-world study on small-cell lung cancer (SCLC) patients aimed to investigate treatment patterns, outcome of re-challenge with platinum doublet chemotherapy (PDCT), and associations between clinical characteristics and survival outcomes.Material and methods: This retrospective single center cohort study was based on patients diagnosed with SCLC between 2008 and 2016 at the Karolinska University Hospital, Stockholm, Sweden. Patients were divided into two subgroups; limited disease (LD), receiving concomitant chemo- and radiotherapy and extensive disease (ED), receiving palliative PDCT. The progression-free survival (PFS) was defined as the interval between the start of CT and the earliest date of documented progression. 'Refractory relapse' (Rr) and 'Sensitive relapse' (Sr) were defined as relapse occurring < or ≥180 days after start of PDCT, respectively. The results for treatment patterns were reported as numbers and percentages of patients, and descriptive analyses including medians and 95% confidence intervals (CIs). The Cox proportional hazards regression model was applied to assess the relationship between clinical characteristics and overall survival (OS).Results: The study included 544 patients; 408 with ED and 136 patients had LD. The median PFS and OS for ED patients were 5.1 and 7.0, respectively. In the ED subgroup, Sr occurred in 169 patients (41%), with a longer median OS when compared to Rr patients (10.8 vs. 3.6 months). Patients with LD had a median PFS and OS of 12 and 24 months, respectively. Some LD patients did not show a sign of relapse (22%). The majority of LD patients who relapsed had Sr (66%), with a longer median OS when compared to patients with Rr (20.9 vs. 7.8 mo).Conclusions: The survival outcomes for ED and LD SCLC patients correspond to historical data. Patients with Sr after 1st line therapy might benefit from re-challenge with PDCT in the 2nd line setting.
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Affiliation(s)
- Salomon Tendler
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Patient Area Head and Neck, Lung, and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Yiqiang Zhan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Pettersson
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Rolf Lewensohn
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Patient Area Head and Neck, Lung, and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Viktorsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Patient Area Head and Neck, Lung, and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Luigi De Petris
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Patient Area Head and Neck, Lung, and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden
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Bright CJ, Lawton S, Benson S, Bomb M, Dodwell D, Henson KE, McPhail S, Miller L, Rashbass J, Turnbull A, Smittenaar R. Data Resource Profile: The Systemic Anti-Cancer Therapy (SACT) dataset. Int J Epidemiol 2020; 49:15-15l. [PMID: 31340008 PMCID: PMC7426029 DOI: 10.1093/ije/dyz137] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Affiliation(s)
- Chloe J Bright
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Sarah Lawton
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Stephen Benson
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Martine Bomb
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - David Dodwell
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Katherine E Henson
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Sean McPhail
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Louise Miller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Jem Rashbass
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Alice Turnbull
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Rebecca Smittenaar
- National Cancer Registration and Analysis Service, Public Health England, London, UK
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11
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Povsic M, Enstone A, Wyn R, Kornalska K, Penrod JR, Yuan Y. Real-world effectiveness and tolerability of small-cell lung cancer (SCLC) treatments: A systematic literature review (SLR). PLoS One 2019; 14:e0219622. [PMID: 31318909 PMCID: PMC6638917 DOI: 10.1371/journal.pone.0219622] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/27/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES SCLC makes up approximately 15% of all lung carcinomas and is characterized by relatively aggressive spread and poorer prognosis compared to other lung cancers. Treatment options are limited, and their efficacy in randomized trials is poor, whilst outcomes in clinical practice remain unclear. The aim of this study was to assess the real-world effectiveness and tolerability of SCLC treatments. METHODS An SLR was conducted across nine databases accessed through OVID, capturing observational, non-randomized studies published between 01/2006-11/2018. In total, 554 abstracts were retrieved and systematically screened for eligibility. The eligible publications included effectiveness and tolerability data from adult SCLC patients (at any line of therapy). Additional grey literature searches were conducted. RESULTS Forty-three publications were included in this review-data from first-line therapies were captured most often (n = 32), while data from second (n = 14) and third line (n = 7) and beyond (n = 7) were less frequent. The publications reported primarily on chemotherapy/radiotherapy. The majority of publications lacked robustness and only 14/43 conducted statistical analyses or controlled for bias. Median OS for the largest SCLC populations were 9.6 months at first line (n = 23,535) and 4.9 months at second line (n = 254) for treatment with chemotherapy, and 4.7 months at third line (n = 120) for predominantly platinum-based chemotherapy or cyclophosphamide/adriamycin/vincristine. Hematologic toxicities (such as neutropenia, thrombocytopenia and anemia) were the most frequently reported TRAEs (n = 9). CONCLUSIONS Real-world treatment effectiveness and tolerability data were fragmented and inconsistently reported, and available publications were primarily of poor quality and lacked statistical analyses. This SLR showed limited treatment options and poor OS in SCLC, with no treatment option being clearly superior. TRAEs additionally increased the burden of this already challenging disease. Recent data suggest real-world outcomes are even poorer that those reported in clinical trials, and that novel therapies are needed to offer new treatment options for patients.
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Affiliation(s)
- Manca Povsic
- Adelphi Values, Bollington, Cheshire, United Kingdom
| | | | - Robin Wyn
- Adelphi Values, Bollington, Cheshire, United Kingdom
| | | | - John R. Penrod
- Bristol-Myers Squibb, Princeton, NJ, United States of America
| | - Yong Yuan
- Bristol-Myers Squibb, Princeton, NJ, United States of America
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