1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Division of Hematology-Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
3Department of Internal Medicine, Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
4Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul, Korea
5Department of Internal Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Korea
6Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
7Division of Hemato-Oncology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
8Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, Seoul, Korea
9Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, Korea
10Division of Oncology, Department of Internal Medicine, Asan Medical Center, Seoul, Korea
11Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea
12Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
13Division of Medical Oncology, Chungbuk National University Hospital, Chungju, Korea
14Division of Hematology-Oncology, Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
15Department of Hematology-Oncology, Ajou University Hospital, Suwon, Korea
16Division of Oncology/Hematology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
17Medical Research Collaborating Center, Seoul National University College of Medicine, Seoul, Korea
Copyright © 2019 by the Korean Cancer Association
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Characteristic | Irinotecan plus cisplatin (n=173) | Etoposide plus cisplatin(n=189) | p-value |
---|---|---|---|
Age, median (range, yr) | 66 (47-80) | 65 (36-81) | 0.128a) |
Sex | |||
Male | 151 (87.2) | 177 (93.6) | 0.038b) |
Female | 22 (12.7) | 12 (63.5) | |
ECOG PS | |||
0 | 16 (9.2) | 19 (10.0) | 0.930b) |
1 | 132 (76.3) | 141 (74.6) | |
2 | 25 (14.4) | 29 (15.3) | |
Bone metastasis | |||
Absent | 61 (35.2) | 71 (37.6) | 0.690b) |
Present | 106 (61.2) | 113 (59.8) | |
Not evaluated | 6 (3.5) | 5 (2.6) | |
Brain metastasis | |||
Absent | 70 (40.4) | 75 (39.7) | 0.978b) |
Present | 47 (27.1) | 50 (26.4) | |
Not evaluated | 56 (32.3) | 64 (33.9) | |
Palliative RT | |||
No | 161 (93.0) | 174 (92.0) | 0.717b) |
Yes | 12 (6.9) | 15 (7.9) |
Confirmed best response | Irinotecan plus cisplatin (n=173) | Etoposide plus cisplatin (n=189) | p-value |
---|---|---|---|
CR | 2 (1.2) | 3 (1.6) | - |
PR | 106 (61.3) | 88 (46.6) | - |
Stable disease | 24 (13.9) | 51 (27.0) | - |
Progressive disease | 4 (2.3) | 18 (9.5) | - |
Not evaluated | 37 (21.4) | 29 (15.3) | - |
Objective response rate (CR+PR) (%) | 62.4 | 48.2 | 0.006a) |
Adverse event | Irinotecan plus cisplatin (n=167) | Etoposide plus cisplatin (n=189) | p-valuea) |
---|---|---|---|
Anemia | 45 (27.0) | 33 (17.5) | 0.035 |
Neutropenia | 104 (62.3) | 134 (71.0) | 0.060 |
Thrombocytopenia | 21 (12.6) | 25 (13.2) | 0.824 |
Neutropenic fever | 31 (18.6) | 33 (17.5) | 0.823 |
Infection | 34 (20.4) | 33 (17.5) | 0.515 |
Nausea | 7 (4.2) | 1 (0.5) | 0.028 |
Vomiting | 5 (3.0) | 3 (1.6) | 0.483 |
Diarrhea | 17 (10.2) | 5 (3.0) | 0.003 |
AST elevation | 2 (1.2) | 8 (4.2) | 0.110 |
ALT elevation | 3 (1.8) | 5 (2.6) | 0.727 |
Present study | Noda et al. [11] | Lara et al. [12] | Hanna et al. [13] | |
---|---|---|---|---|
Regimen | Irinotecan 65 mg/m2 D 1,8 | Irinotecan 60 mg/m2 D 1,8,15 | Irinotecan 60 mg/m2 D 1,8,15 | Irinotecan 65 mg/m2 D 1,8 |
Cisplatin 70 mg/m2 D 1 | Cisplatin 60 mg/m2 D 1 | Cisplatin 60 mg/m2 D 1 | Cisplatin 30 mg/m2 D 1,8 | |
every 3 wk | every 4 wk | every 4 wk | every 3 wk | |
No. of patients | 362 | 154 | 651 | 331 |
Median OS (mo) | 10.9 | 12.8 | 9.9 | 9.3 |
Median PFS (mo) | 6.5 | 6.9 | 5.8 | 4.1 |
Response rate (%) | 62.4 | 65.0 | 60.0 | 48.0 |
Grade 3/4 neutropenia (%) | 62.3 | 65.3 | 34.0 | 36.2 |
Grade 3/4 diarrhea (%) | 10.2 | 16.0 | 19.0 | 21.3 |
A Retrospective Cohort Study on Pretreated Neutrophil-to-Lymphocyte Ratio and Prognosis of Small Cell Lung Cancer: Evidence of Effect Modification by Chemotherapy Regimen
Characteristic | Irinotecan plus cisplatin (n=173) | Etoposide plus cisplatin(n=189) | p-value |
---|---|---|---|
Age, median (range, yr) | 66 (47-80) | 65 (36-81) | 0.128 |
Sex | |||
Male | 151 (87.2) | 177 (93.6) | 0.038 |
Female | 22 (12.7) | 12 (63.5) | |
ECOG PS | |||
0 | 16 (9.2) | 19 (10.0) | 0.930 |
1 | 132 (76.3) | 141 (74.6) | |
2 | 25 (14.4) | 29 (15.3) | |
Bone metastasis | |||
Absent | 61 (35.2) | 71 (37.6) | 0.690 |
Present | 106 (61.2) | 113 (59.8) | |
Not evaluated | 6 (3.5) | 5 (2.6) | |
Brain metastasis | |||
Absent | 70 (40.4) | 75 (39.7) | 0.978 |
Present | 47 (27.1) | 50 (26.4) | |
Not evaluated | 56 (32.3) | 64 (33.9) | |
Palliative RT | |||
No | 161 (93.0) | 174 (92.0) | 0.717 |
Yes | 12 (6.9) | 15 (7.9) |
Confirmed best response | Irinotecan plus cisplatin (n=173) | Etoposide plus cisplatin (n=189) | p-value |
---|---|---|---|
CR | 2 (1.2) | 3 (1.6) | - |
PR | 106 (61.3) | 88 (46.6) | - |
Stable disease | 24 (13.9) | 51 (27.0) | - |
Progressive disease | 4 (2.3) | 18 (9.5) | - |
Not evaluated | 37 (21.4) | 29 (15.3) | - |
Objective response rate (CR+PR) (%) | 62.4 | 48.2 | 0.006 |
Adverse event | Irinotecan plus cisplatin (n=167) | Etoposide plus cisplatin (n=189) | p-value |
---|---|---|---|
Anemia | 45 (27.0) | 33 (17.5) | 0.035 |
Neutropenia | 104 (62.3) | 134 (71.0) | 0.060 |
Thrombocytopenia | 21 (12.6) | 25 (13.2) | 0.824 |
Neutropenic fever | 31 (18.6) | 33 (17.5) | 0.823 |
Infection | 34 (20.4) | 33 (17.5) | 0.515 |
Nausea | 7 (4.2) | 1 (0.5) | 0.028 |
Vomiting | 5 (3.0) | 3 (1.6) | 0.483 |
Diarrhea | 17 (10.2) | 5 (3.0) | 0.003 |
AST elevation | 2 (1.2) | 8 (4.2) | 0.110 |
ALT elevation | 3 (1.8) | 5 (2.6) | 0.727 |
Treatment | Irinotecan plus cisplatin (n=173) | Etoposide plus cisplatin (n=189) |
---|---|---|
No systemic treatment | 72 (41.6) | 73 (38.6) |
Etoposide containing regimen | 84 (48.6) | 9 (4.8) |
Irinotecan containing regimen | 10 (5.8) | 65 (34.4) |
Cyclophosphamide+doxorubicin+vincristine | 30 (17.3) | 26 (13.8) |
Topotecan or belotecan | 15 (8.7) | 39 (20.6) |
Paclitaxel | 8 (4.6) | 11 (5.8) |
Ifosfamide | 6 (3.5) | 5 (2.6) |
Others | 12 (6.9) | 11 (5.8) |
Present study | Noda et al. [11] | Lara et al. [12] | Hanna et al. [13] | |
---|---|---|---|---|
Regimen | Irinotecan 65 mg/m2 D 1,8 | Irinotecan 60 mg/m2 D 1,8,15 | Irinotecan 60 mg/m2 D 1,8,15 | Irinotecan 65 mg/m2 D 1,8 |
Cisplatin 70 mg/m2 D 1 | Cisplatin 60 mg/m2 D 1 | Cisplatin 60 mg/m2 D 1 | Cisplatin 30 mg/m2 D 1,8 | |
every 3 wk | every 4 wk | every 4 wk | every 3 wk | |
No. of patients | 362 | 154 | 651 | 331 |
Median OS (mo) | 10.9 | 12.8 | 9.9 | 9.3 |
Median PFS (mo) | 6.5 | 6.9 | 5.8 | 4.1 |
Response rate (%) | 62.4 | 65.0 | 60.0 | 48.0 |
Grade 3/4 neutropenia (%) | 62.3 | 65.3 | 34.0 | 36.2 |
Grade 3/4 diarrhea (%) | 10.2 | 16.0 | 19.0 | 21.3 |
Values are presented as number (%) unless otherwise indicated. ECOG PS, Eastern Cooperative Oncology Group performance status; RT, radiation therapy. Wilcoxon rank sum test, Chi-square test.
Values are presented as number (%) unless otherwise indicated. CR, complete response; PR, partial response. Chi-square test.
Values are presented as number (%). Chi-square test.
Values are presented as number (%).
ED, extensive-disease; SCLC, small-cell lung cancer; D, day; OS, overall survival; PFS, progression-free survival.