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Title: Third-line chemotherapy in small-cell lung cancer: an international analysis.
Austin Authors: Simos, Demetrios;Sajjady, Golmehr;Sergi, Melissa;Liew, Mun Sem;Califano, Raffaele;Ho, Cheryl;Leighl, Natasha;White, Shane C;Summers, Yvonne;Petrcich, William;Wheatley-Price, Paul
Affiliation: The Ottawa Hospital Research Institute, Clinical Epidemiology Program, Methods Centre, Ottawa, Ontario, Canada
Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Joint Austin-Ludwig Oncology Unit, Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Australia
Division of Medical Oncology, Princess Margaret Hospital Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada
Division of Medical Oncology, The British Columbia Cancer Agency and University of British Columbia, Vancouver, British Columbia, Canada
Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom.
Issue Date: 14-Nov-2013
Publication information: Clinical Lung Cancer 2013; 15(2): 110-8
Abstract: Small-cell lung cancer is an aggressive disease for which the mainstay of treatment is chemotherapy. Despite good initial responses most patients will relapse. Some will receive second-line therapy with clinical benefit, but for third-line chemotherapy there is little evidence to guide treatment decisions and the benefits of treatment are unknown. This study investigated the treatment of SCLC in the third-line setting.An international, multicenter retrospective analysis of patients who received at least 3 lines of chemotherapy for their SCLC was performed.From 2000 to 2010, 120 patients were identified from 5 centers: median age 61, 40% (n = 72) limited stage, and 79% (n = 95) Eastern Cooperative Oncology Group performance status of 0 to 1. Only 22% of these patients received 3 distinct lines of chemotherapy. The remainder were rechallenged with a chemotherapy regimen used at least once previously. Six percent received platinum-based chemotherapy in all 3 lines. In third-line, response rate was 18% and median overall survival was 4.7 months. Factors associated with longer survival included normal baseline LDH levels and response to second-line chemotherapy. On multivariate analysis only normal baseline LDH retained statistical significance. Thirty-five patients went on to receive chemotherapy beyond the third line.Few SCLC patients receive 3 chemotherapy lines. Most patients were rechallenged with a similar regimen at least once. Response and survival in the third-line setting are modest. Lack of response to second-line chemotherapy and elevated baseline LDH level might predict lack of benefit from third-line treatment. This data set does not include patients receiving fewer lines for comparison.
Gov't Doc #: 24365050
DOI: 10.1016/j.cllc.2013.11.003
Type: Journal Article
Subjects: Outcomes
Retrospective review
Small cell lung cancer
Appears in Collections:Journal articles

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