Share This Article:

Analysis of prognostic factors for overall survival in patients with advanced non-small cell lung cancer treated with second line chemotherapy

Abstract Full-Text HTML Download Download as PDF (Size:654KB) PP. 55-61
DOI: 10.4236/alc.2013.23007    3,432 Downloads   10,577 Views  

ABSTRACT

Aim: The aim of this study was to investigate prognostic factors for survival in patients with advanced NSCLC who receiving second-line chemotherapy. Methods: We retrospectively reviewed data of 116 patients with NSCLC receiving second-line treatments from October 2010 to December 2012 in Clinic for Lung Diseases of Clinical center Nis, Department for Pulmonary Oncology. Thirteen potential prognostic factors were chosen for analysis. Univariate analysis was conducted to identify prognostic factors associated with progression free survival and overall survival. Multivariate analysis included the prognostic significance factors in univariate analysis. Results: The univariate analysis for progression free survival (PFS) and overall survival (OS) was identified to have prognostic significance: performance status, smoking, weight loss, comorbidity, number of meta localization, first-line chemotherapy regimen and response to first-line chemotherapy. Nevertheless, multivariate Cox prortional hazard regression analysis showed that performance status (PFS: p = 0.000, OS: p = 0.000) weight loss ≥ 5% (PFS: p = 0.000, OS: p = 0.002), comorbidity (PFS: p = 0.001, OS: p = 0.012) and four places of meta localization (PFS: p = 0.021, OS: p = 0.021) were considered independent prognostic factors for both, progression free survival and overall survival. Conclusion: Performance status, weight loss ≥ 5%, comorbidity and higher number of meta localization were identified as prognostic factors for survival in advanced NSCLC patients receiving second-line chemotherapy treatment. These findings may help pretreatment prediction of survival and may facilitate in the future integration new agents into second-line treatment.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Rancic, M. , Ristic, L. , Cekic, M. and Pejcic, T. (2013) Analysis of prognostic factors for overall survival in patients with advanced non-small cell lung cancer treated with second line chemotherapy. Advances in Lung Cancer, 2, 55-61. doi: 10.4236/alc.2013.23007.

References

[1] Jemal, A., Siegel, R., Ward, E., Murray, T., Xu, J. and Thun, M.J. (2007) Cancer statistics. CA—A Cancer Journal for Clinicians, 57, 43-66. doi:10.3322/canjclin.57.1.43
[2] Boyle, P. and Ferlay, J. (2004) Cancer incidence and mortality in Europe, 2004. Annals of Oncology, 16, 481-488. doi:10.1093/annonc/mdi098
[3] Socinski, M.A., Morris, D.E., Masters, G.A. and Lilenbaum, R. (2003) Chemotherapeutic management of stage IV non-small cell lung cancer. Chest, 123, 226S-243S. doi:10.1378/chest.123.1_suppl.226S
[4] Siegel, R., Ward, E., Brawley, O. and Jemal, A. (2011) Cancer statistics, 2011: The impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA—A Cancer Journal for Clinicians, 61, 212-236. doi:10.3322/caac.20121
[5] Schiller, J.H., Harrington, D., Belani, C.P., Langer, C., Sandler, A., Krook, J., Zhu, J. and Johnson, D.H. (2002) Comparison of four chemotherapy regimens for advanced non-small cell lung cancer. The New England Journal of Medicine, 346, 92-98. doi:10.1056/NEJMoa011954
[6] NSCLC Meta-Analyses Collaborative Group (2008) Chemotherapy in addition to supportive care improves survival in advanced non-small-cell lung cancer: A systematic review and meta-analysis of individual patient data from 16 randomized controlled trials. Journal of Clinical Oncology, 26, 4617-4625. doi:10.1200/JCO.2008.17.7162
[7] Azzoli, C.G., Baker Jr., S., Temin, S., Pao, W., Aliff. T., Brahmer, J., Johnson, D.H., Laskin, J.L., Masters, G., Milton, D., Nordquist, L., Pfister, D.G., Piantadosi, S., Schiller, J.H., Smith, R., Smith, T.J., Strawn, J.R., Trent, D. and Giaccone, G. (2009) American society of clinical oncology clinical practice guideline update on chemotherapy for stage IV non-small-cell lung cancer. Journal of Clinical Oncology, 27, 6251-6266. doi:10.1200/JCO.2009.23.5622
[8] Kelly, K., Crowley, J., Bunn Jr., P.A., Presant, C.A., Grevstad, P.K., Moinpour, C.M., Ramsey, S.D., Wozniak, A.J., Weiss, G.R., Moore, D.F., Israel, V.K., Livingston, R.B. and Gandara, D.R. (2001) Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patients with advanced nonsmall cell lung cancer: A Southwest Oncology Group trial. Journal of Clinical Oncology, 19, 3210-3218.
[9] Sandler, A., Gray, R., Perry, M.C., Brahmer, J., Schiller, J.H., Dowlati, A., Lilenbaum, R. and Johnson, D.H. (2006) Paclitaxel-carboplatin alone or with bevacizumab for non-small cell lung cancer. The New England Journal of Medicine, 355, 2542-2550. doi:10.1056/NEJMoa061884
[10] Socinski, M.A., Schell, M.J., Peterman, A., Bakri, K., Yates, S., Gitten, R., Unger, P., Lee, J., Lee, J.H., Tynan, M., Moore, M. and Kies, M.S. (2002) Phase III trial comparing a defined duration of therapy versus continuous therapy followed by second-line therapy in advancedstage IIIB/IV non-small-cell lung cancer. Journal of Clinical Oncology, 20, 1335-1343. doi:10.1200/JCO.20.5.1335
[11] Hensing, T.A., Schell, M.J., Lee, J.H. and Socinski, M.A. (2005) Factors associated with the likelihood of receiving second line therapy for advanced non-small cell lung cancer. Lung Cancer, 47, 253-259. doi:10.1016/j.lungcan.2004.07.040
[12] NCCN Clinical Practice Guidelines in Oncology (2012) Non-small cell lung cancer. Version 2, MS30-MS31. http://www.nccn.com/
[13] Eisenhauer, E.A., Therasse, P., Bogaerts, J., Schwartz, L.H., Sargent, D., Ford, R., Dancey, J., Arbuck, S., Gwyther, S., Mooney, M., Rubinstein, L., Shankar, L., Dodd, L., Kaplan, R., Lacombe, D. and Verweij, J. (2009) New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). European Journal of Cancer, 45, 28-47. doi:10.1016/j.ejca.2008.10.026
[14] Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P. (1982) Toxicity And Response Criteria Of The Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649-655. doi:10.1097/00000421-198212000-00014
[15] Zhang, X., Zang, J., Xu, J., Bai, C., Qin, Y., Liu, K., Wu, C., Wu, M., He, Q., Zhang, S., Wei, L. and He, J. (2011) Maintenance therapy with continuous or switch strategy in advanced non-small-cell lung cancer: A systematic review and meta-analysis. Chest, 140, 117-126. doi:10.1378/chest.10-2745
[16] Shepherd, F.A., Dancey, J., Ramlau, R., Mattson, K., Gralla, R., O’Rourke, M., Levitan, N., Gressot, L., Vincent, M., Burkes, R., Coughlin, S., Kim, Y. and Berille, J. (2000) Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. Journal of Clinical Oncology, 18, 2095-2103.
[17] Fossella, F.V., DeVore, R., Kerr, R.N., Crawford, J., Natale, R.R., Dunphy, F., Kalman, L., Miller, V., Lee, J.S., Moore, M., Gandara, D., Karp, D., Vokes, E., Kris, M., Kim, Y., Gamza, F. and Hammershaimb, L. (2000) Randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. The TAX 320 Non-Small Cell Lung Cancer Study Group. Journal of Clinical Oncology, 18, 2354-2362.
[18] Ciuleanu, T., Brodowicz, T., Zielinski, C., Kim, J.H., Krzakowski, M., Laack, E., Wu, Y.L., Bover, I., Begbie, S., Tzekova, V., Cucevic, B., Pereira, J.R., Yang, S.H., Madhavan, J., Sugarman, K.P., Peterson, P., John, W.J., Krejcy, K. and Belani, C.P. (2009) Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: A randomised, double-blind, phase 3 study. Lancet, 374, 1432-1440. doi:10.1016/S0140-6736(09)61497-5
[19] Bonomi, P., Langer, C., O’Brien, M., O’Byrne, K., Bandstra, B., Paz-Ares, L., Ross, H., Sandler, A. and Socinski, M. (2006) Analysis of prognostic factors in patients with advanced relapsed/refractory NSCLC: Cox regression analysis of a randomized phase III trial comparing docetaxel and paclitaxel poliglumex (PPX). Journal of Clinical Oncology, 24, 374s.
[20] Younes, R.N., Pereira, J.R., Fares, A.L. and Gross, J.L. (2011) Chemotherapy beyond first-line in stage IV metastatic non-small cell lung cancer. Revista da Associa??o Médica Brasileira, 57, 686-691. doi:10.1590/S0104-42302011000600017
[21] Zietemann, V. and Duell, T. (2011) Prevalence and effectiveness of firs-, second-, and third-line systemic therapy in cohort of unselected patients with advanced non-small cell lung cancer. Lung Cancer, 73, 70-77. doi:10.1016/j.lungcan.2010.10.017
[22] Scartozzi, M., Mazzanti, P., Giampieri, R., Berardi, R., Galizia, E., Gasparini, S., Zuccatosta, L. and Cascinu, S. (2010) Clinical predictive factors for advanced non-small cell lung cancer (NSCLC) patients receiving third-line therapy: Selecting the unselectable? Lung Cancer, 68, 433-437. doi:10.1016/j.lungcan.2009.07.008
[23] Wataya, H., Okamoto, T., Maruyama, R., Seto, T., Yamazaki, K., Tagawa, T., Fukuyama, S., Osoegawa, A., Ikeda, J., Nishimura, M., Yamanaka, T. and Ichinose, Y. (2009) Prognostic factors in previously treated non-small cell lung cancer patients with and without a positive response to the subsquent treatment with gefitinib. Lung Cancer, 64, 341-345. doi:10.1016/j.lungcan.2008.09.005
[24] Di Maio, M., Lama, N., Morabito, A., Smit, E.F., Georgoulias, V., Takeda, K., Quoix, E., Hatzidaki, D., Wachters, F.M., Gebbia, V., Tsai, C.M., Camps, C., Schuette, W., Chiodini, P., Piccirillo, M.C., Perrone, F., Gallo, C. and Gridelli, C. (2010) Clinical assessment of patients with advanced non-small-cell lung cancer eligible for second-line chemotherapy: A prognostic score from individual data of nine randomised trials. European Journal of Cancer, 46, 735-743. doi:10.1016/j.ejca.2009.12.013
[25] Di Maio, M., Krzakowski, M., Fougeray, R., Kowalski, D.M. and Gridelli, C. (2012) Prognostic score for secondline chemotherapy of advanced non-small-cell lung cancer: External validation in a phase III trial comparing vinflunine with docetaxel. Lung Cancer, 77, 116-120. doi:10.1016/j.lun gcan.2012.01.013
[26] Weiss, G.J., Rosell, R., Fossella, F., Perry, M., Stahel, R., Barata, F., Nguyen, B., Paul, S., McAndrews, P., Hanna, N., Kelly, K., Bunn Jr., P.A., (2007) The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer. Annals of Oncology, 18, 453-460. doi:10.1093/annonc/mdl454
[27] Inal, A., Kaplan, M.A., Kucukoner, M., Urakci, Z., Karakus, A. and Isikdogan, A. (2012) Prognostic factors for second-line tretment of advanced non-small-cell Lung Cancer: Retrospective analysis at a single institution. Asian Pacific Journal of Cancer Prevention, 13, 1281-1284. doi:10.7314/APJCP.2012.13.4.1281
[28] Smit, E.F., Mattson, K., von Pawel, J., Manegold, C., Clarke, S. and Postmus, P.E. (2003) ALIMTA (pemetrexed disodium) as second-line treatment of non-small-cell lung cancer: A phase II study. Annals of Oncology, 14, 455-460. doi:10.1093/annonc/mdg099
[29] Rusthoven, J.J., Eisenhauer, E., Butts, C., Gregg, R., Dancey, J., Fisher, B. and Iglesias, J. (1999) Multitargeted antifolate LY231514 as first-line chemotherapy for patients with advanced nonsmall-cell lung cancer: A phase II study. National Cancer Institute of Canada Clinical Trials Group. Journal of Clinical Oncology, 17, 1194.
[30] Hanna, N., Shepherd, F.A., Fossella, F.V., Pereira, J.R., De Marinis, F., von Pawel, J., Gatzemeier, U., Tsao, T.C., Pless, M., Muller, T., Lim, H.L., Desch, C., Szondy, K., Gervais, R., Shaharyar, Manegold, C., Paul, S., Paoletti, P., Einhorn, L. and Bunn Jr., P.A., (2004) Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. Journal of Clinical Oncology, 22, 1589-1597. doi:10.1200/JCO.2004.08.163
[31] Weiss, G.J., Langer, C. and Rosell, R. (2006) Elderly patients benefit from second-line cytotoxic chemotherapy: A subset analysis of a randomized phase III trial of pemetrexed compared with docetaxel in patients with previously treated advanced non-small-cell lung cancer. Journal of Clinical Oncology, 24, 4405-4411. doi:10.1200/JCO.2006.06.7835
[32] Kim, J.G., Ryoo, B.Y., Park, Y.H., Kim, B.S., Kim, T.Y., Im, Y.H. and Kang, Y.K. (2008) Prognostic factors for survival of patients with advanced gastric cancer treated with cisplatin-based chemotherapy. Cancer Chemotherapy and Pharmacology, 61, 301-307. doi:10.1007/s00280-007-0476-x
[33] Krishnan, S., Rana, V., Janjan, N.A., Abbruzzese, J.L., Gould, M.S., Das, P., Delclos, M.E., Palla, S., Guha, S., Varadhachary, G., Evans, D.B., Wolff, R.A. and Crane, C.H. (2006) Prognostic factors in patients with unresectable locally advanced pancreatic adenocarcinoma treated with chemoradiation. Cancer, 107, 2589-2596. doi:10.1002/cncr.22328

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.