Prognostic factors for second-line chemotherapy of metastatic non-small-cell lung cancer

##plugins.themes.academic_pro.article.main##

Saoussen Bacha
Hela Cherif
Sonia Habibech
Améni sghaier
Sana Cheikhrouhou
Hager Racil
Naouel Chaouch
Mohamed Lamine Megdiche
Abdellatif Chabbou

Abstract

Background: Few studies have been conduct¬ed to determine prognostic factors of second-line chemotherapy. The aim of this study was to determine the prognostic factors for survival in patients receiving second-line treatment for advanced NSCLC.
Methods: We retrospectively reviewed the records of 71 patients with metastatic NSCLC who received second-line chemotherapy from January 2006 to January 2013.
Results:The mean age was 57 years. All patients were male. The performance status was 0 or 1 in 90.1% of cases. Sixty-four patients received a first line platinum-based chemotherapy. The second line chemotherapy regimen was docetaxel in 31 cases and pemetrexed in 18 cases. Fourteen patients (19.71%) had received third-line chemotherapy. The median overall survival was 13.5 months. Age older than 65 years (p=0.025), advanced T stage (T4 versus T3 and T2; p=0.01), advanced N stage (N3 versus N2 and N1; p=0.001), lower level hemoglobin (p=0.05) and non-responders who showed progression with first-line chemotherapy (p=0.04) were significant negative predictors in univariate analysis for overall survival (OS). The multivariate analysis showed that age≥ 65 years (HR=2.15; 95% CI[1.26−2.44]), advanced N stage (HR=2.273; 95% CI [1.26−2.44]) were independent prognostic factors for OS.
Conclusion: Age and advanced N stage were important factors in predicting the outcome of advanced NSCLC patients who were undergoing second-line chemotherapy.

Keywords:

Non-small cell lung cancer, chemotherapy, second line, prognosis

##plugins.themes.academic_pro.article.details##

References

  1. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of Four Chemotherapy Regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346(2):92‑8.
  2. Di Maio M, Lama N, Morabito A, Smit EF, Georgoulias V, Takeda K, et al. 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. Eur J Cancer 2010;46(4):735‑43.
  3. Hanna N, Shepherd F, Fossella F. Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol 2004;22(9):1589-97
  4. Shepherd FA, Dancey J, Ramlau R, Mattson K, Gralla R, O'Rourke M, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 2000;18(10):2095‑103.
  5. Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, et al. Erlotinib in Previously Treated Non-Small-Cell Lung Cancer. N Engl J Med 2005;353(2):123-32.
  6. Thatcher N, Chang A, Parikh P, Rodrigues Pereira J, Ciuleanu T, von Pawel J, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 2005;366(9496):1527‑37.
  7. Cullen M, Thatcher N. Gefitinib or docetaxel in advanced non-small-cell lung cancer. Lancet 2008; 372:1785‑6.
  8. Hensing TA, Schell MJ, Lee J, Socinski MA. Factors associated with the likelihood of receiving second line therapy for advanced non-small cell lung cancer. Lung Cancer 2005;47(2):253‑9.
  9. Di Maio M, Krzakowski M, Fougeray R, Kowalski DM, Gridelli C. Prognostic score for second-line chemotherapy of advanced non-small-cell lung cancer: External validation in a phase III trial comparing vinflunine with docetaxel. Lung Cancer 2012;77(1):116‑20.
  10. Wu C-H, Fan W-C, Chen Y-M, Chou K-T, Shih J-F, Tsai C-M, et al. Second-line therapy for elderly patients with non-small cell lung cancer who failed previous chemotherapy is as effective as for younger patients. J Thorac Oncol 2010;5(3):376‑9.
  11. Lee SJ, Kang HJ, Kim SW, Ryu YJ, Ph D, Lee H, et al. Outcomes of Second-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in One Institution. Tuberc Respir Dis 2014;77(1):13‑7.
  12. Weiss GJ, Rosell R, Fossella F, Perry M, Stahel R, Barata F, et al. 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. Ann Oncol 2007;18(3):453‑60.
  13. Odabas H, Ulas A, Aydin K, Inanc M, Aksoy A, Yazilitas D, et al. Is second-line systemic chemotherapy beneficial in patients with non-small cell lung cancer (NSCLC)? A multicenter data evaluation by the Anatolian Society of Medical Oncology. Tumor Biol 2015;36(12):9641‑8.
  14. Wataya H, Okamoto T, Maruyama R, Seto T, Yamazaki K, Tagawa T, et al. Prognostic factors in previously treated non-small cell lung cancer patients with and without a positive response to the subsequent treatment with gefitinib. Lung Cancer 2009;64(3):341‑5.
  15. Scartozzi M, Mazzanti P, Giampieri R, Berardi R, Galizia E, Gasparini S, et al. Clinical predictive factors for advanced non-small cell lung cancer (NSCLC) patients receivingthird-line therapy: Selecting the unselectable? Lung Cancer 2010;68(3):433‑7.
  16. Zietemann V, Duell T. Prevalence and effectiveness of first, second, and third-line systemic therapy in a cohort of unselected patients with advanced non-small cell lung cancer. Lung Cancer 2011;73(1):70‑7.