Skip to main content

Advertisement

SpringerLink
Log in

The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Recent studies have suggested that, among patients with advanced lung cancer, subsequent treatment after failure of first-line or second-line chemotherapy has a greater effect on overall survival (OS) than tumor shrinkage or progression-free survival (PFS). However, no studies have examined this issue among patients with sensitive relapse of small cell lung cancer (SCLC). We retrospectively evaluate 77 patients with sensitive relapse of SCLC who received second-line chemotherapy after first-line platinum doublet chemotherapy between January 1999 and November 2013. The analyses included patient characteristics, treatment parameters, tumor shrinkage, PFS, post-progression survival (PPS), and OS. Spearman rank correlation analysis and linear regression analysis revealed that PPS was strongly correlated with OS (r = 0.91, p < 0.01, R2 = 0.96), PFS was moderately correlated with OS (r = 0.58, p < 0.01, R2 = 0.28), and tumor shrinkage was weakly correlated with OS (r = 0.34, p < 0.01, R2 = 0.12). A multivariate Cox proportional hazards model with a stepwise regression procedure revealed that PPS was significantly associated with age at the start of second-line chemotherapy, best response to second-line and third-line chemotherapy, and the number of regimens after progression beyond second-line chemotherapy (p < 0.05). These findings suggest that PPS has a stronger effect than PFS on OS among patients with sensitive relapse of SCLC. Thus, response to second-line chemotherapy and subsequent treatment for disease progression after second-line chemotherapy may be important factors that influence OS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer. Lancet. 2011;378:1741–55.

    Article  PubMed  Google Scholar 

  2. Noda K, Nishiwaki Y, Kawahara M, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med. 2002;346:85–91.

    Article  CAS  PubMed  Google Scholar 

  3. Faivre-Finn C, Snee M, Ashcroft L, et al. Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial. Lancet Oncol. 2017;18:1116–25.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ardizzoni A, Hansen H, Dombernowsky P, et al. Topotecan, a new active drug in the second-line treatment of small-cell lung cancer: a phase II study in patients with refractory and sensitive disease. The European Organization for Research and Treatment of Cancer Early Clinical Studies Group and New Drug Development Office, and the Lung Cancer Cooperative Group. J Clin Oncol. 1997;15:2090–6.

    Article  CAS  PubMed  Google Scholar 

  5. Kim YH, Goto K, Yoh K, et al. Performance status and sensitivity to first-line chemotherapy are significant prognostic factors in patients with recurrent small cell lung cancer receiving second-line chemotherapy. Cancer. 2008;113:2518–23.

    Article  PubMed  Google Scholar 

  6. O’Brien ME, Ciuleanu TE, Tsekov H, et al. Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small-cell lung cancer. J Clin Oncol. 2006;24:5441–7.

    Article  PubMed  Google Scholar 

  7. Eckardt JR, von Pawel J, Pujol JL, et al. Phase III study of oral compared with intravenous topotecan as second-line therapy in small-cell lung cancer. J Clin Oncol. 2007;25:2086–92.

    Article  CAS  PubMed  Google Scholar 

  8. Goto K, Ohe Y, Shibata T, et al. Combined chemotherapy with cisplatin, etoposide, and irinotecan versus topotecan alone as second-line treatment for patients with sensitive relapsed small-cell lung cancer (JCOG0605): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2016;17:1147–57.

    Article  CAS  PubMed  Google Scholar 

  9. Inoue A, Sugawara S, Yamazaki K, et al. Randomized phase II trial comparing amrubicin with topotecan in patients with previously treated small-cell lung cancer: North Japan Lung Cancer Study Group Trial 0402. J Clin Oncol. 2008;26:5401–6.

    Article  CAS  PubMed  Google Scholar 

  10. Murakami H, Yamamoto N, Shibata T, et al. A single-arm confirmatory study of amrubicin therapy in patients with refractory small-cell lung cancer: Japan Clinical Oncology Group Study (JCOG0901). Lung Cancer. 2014;84:67–72.

    Article  PubMed  Google Scholar 

  11. Hirose T, Horichi N, Ohmori T, et al. Phase II study of irinotecan and carboplatin in patients with the refractory or relapsed small cell lung cancer. Lung Cancer. 2003;40:333–8.

    Article  PubMed  Google Scholar 

  12. Inoue A, Sugawara S, Maemondo M, et al. Randomized phase II trial comparing amrubicin with re-challenge of platinum doublet in patients with sensitive-relapsed small-cell lung cancer: North Japan Lung Cancer Study Group Trial 0702. Lung Cancer. 2015;89:61–5.

    Article  PubMed  Google Scholar 

  13. Soria JC, Massard C, Le Chevalier T. Should progression-free survival be the primary measure of efficacy for advanced NSCLC therapy? Ann Oncol. 2010;21:2324–32.

    Article  CAS  PubMed  Google Scholar 

  14. Tiseo M, Boni L, Ambrosio F, et al. Italian, multicenter, phase III, randomized study of cisplatin plus etoposide with or without bevacizumab as first-line treatment in extensive-disease small-cell lung cancer: the GOIRC-AIFA FARM6PMFJM trial. J Clin Oncol. 2017;35:1281–7.

    Article  CAS  PubMed  Google Scholar 

  15. von Pawel J, Jotte R, Spigel DR, et al. Randomized phase III trial of amrubicin versus topotecan as second-line treatment for patients with small-cell lung cancer. J Clin Oncol. 2014;32:4012–9.

    Article  Google Scholar 

  16. Imai H, Kaira K, Minato K. Clinical significance of post-progression survival in lung cancer. Thorac Cancer. 2017;8:379–86.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Broglio KR, Berry DA. Detecting an overall survival benefit that is derived from progression-free survival. J Natl Cancer Inst. 2009;101:1642–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Hotta K, Kiura K, Fujiwara Y, et al. Role of survival post-progression in phase III trials of systemic chemotherapy in advanced non-small-cell lung cancer: a systematic review. PLoS ONE. 2011;6:e26646.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hayashi H, Okamoto I, Morita S, et al. Postprogression survival for first-line chemotherapy of patients with advanced non-small-cell lung cancer. Ann Oncol. 2012;23:1537–41.

    Article  CAS  PubMed  Google Scholar 

  20. Hayashi H, Okamoto I, Taguri M, et al. Postprogression survival in patients with advanced non-small-cell lung cancer who receive second-line or third-line chemotherapy. Clin Lung Cancer. 2013;14:261–6.

    Article  PubMed  Google Scholar 

  21. Yoshino R, Imai H, Mori K, et al. Surrogate endpoints for overall survival in advanced non-small-cell lung cancer patients with mutations of the epidermal growth factor receptor gene. Mol Clin Oncol. 2014;2:731–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Imai H, Takahashi T, Mori K, et al. Individual-level data on the relationships of progression-free survival, post-progression survival, and tumor response with overall survival in patients with advanced non-squamous non-small cell lung cancer. Neoplasma. 2014;61:233–40.

    Article  CAS  PubMed  Google Scholar 

  23. Kasahara N, Imai H, Kaira K, et al. Clinical impact of post-progression survival on overall survival in patients with limited-stage disease small cell lung cancer after first-line chemoradiotherapy. Radiol Oncol. 2015;49:409–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Imai H, Mori K, Watase N, et al. Clinical impact of post-progression survival on overall survival in elderly patients with extensive disease small-cell lung cancer. Thorac Cancer. 2016;7:655–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Kotake M, Miura Y, Imai H, et al. Post-progression survival associated with overall survival in patients with advanced non-small-cell lung cancer receiving docetaxel monotherapy as second-line chemotherapy. Chemotherapy. 2017;62:205–13.

    Article  CAS  PubMed  Google Scholar 

  26. Imai H, Mori K, Ono A, et al. Individual-level data on the relationships of progression-free survival and post-progression survival with overall survival in patients with advanced non-squamous non-small cell lung cancer patients who received second-line chemotherapy. Med Oncol. 2014;31:88.

    Article  PubMed  Google Scholar 

  27. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.

    Article  CAS  PubMed  Google Scholar 

  28. Foster NR, Qi Y, Shi Q, et al. Tumor response and progression-free survival as potential surrogate endpoints for overall survival in extensive stage small-cell lung cancer: findings on the basis of North Central Cancer Treatment Group Trials. Cancer. 2011;117:1262–71.

    Article  PubMed  Google Scholar 

  29. Foster NR, Renfro LA, Schild SE, et al. Multitrial evaluation of progression-free survival as a surrogate end point for overall survival in first-line extensive-stage small-cell lung cancer. J Thorac Oncol. 2015;10:1099–106.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Imai H, Mori K, Wakuda K, et al. Progression-free survival, post-progression survival, and tumor response as surrogate markers for overall survival in patients with extensive small cell lung cancer. Ann Thorac Med. 2015;10:61–6.

    PubMed  PubMed Central  Google Scholar 

  31. Inomata M, Hayashi R, Tokui K, et al. Outcome and prognostic factors in patients with small cell lung cancer who receive third-line chemotherapy. Tumori. 2014;100:507–11.

    Article  PubMed  Google Scholar 

  32. Saruwatari K, Umemura S, Nomura S, et al. Prognostic factor analysis in patients with small-cell lung cancer treated with third-line chemotherapy. Clin Lung Cancer. 2016;17:581–7.

    Article  PubMed  Google Scholar 

  33. Rudin CM, Pietanza MC, Bauer TM, et al. Rovalpituzumab tesirine, a DLL3-targeted antibody-drug conjugate, in recurrent small-cell lung cancer: a first-in-human, first-in-class, open-label, phase 1 study. Lancet Oncol. 2017;18:42–51.

    Article  CAS  PubMed  Google Scholar 

  34. Antonia SJ, Lopez-Martin JA, Bendell J, et al. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial. Lancet Oncol. 2016;17:883–95.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Sakae Fujimoto (Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Japan) and Dr. Masanobu Yamada (Department of Endocrinology and Diabetes, Gunma University Graduate School of Medicine, Japan) for assisting with the preparation of the manuscript.

Author information

Authors and Affiliations

  1. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashinishi-machi, Ota, Gunma, Japan

    Yosuke Miura, Hisao Imai & Koichi Minato

  2. Department of Respiratory Medicine, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Yosuke Miura, Reiko Sakurai, Noriaki Sunaga & Takeshi Hisada

  3. Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, 383, Shiroi, Shibukawa, Gunma, Japan

    Reiko Sakurai & Ryusei Saito

  4. Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Kyoichi Kaira

Authors
  1. Yosuke Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hisao Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Reiko Sakurai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyoichi Kaira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Noriaki Sunaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Koichi Minato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryusei Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takeshi Hisada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hisao Imai.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The study’s protocol complied with the Declaration of Helsinki and was approved by the institutional review boards of Gunma Prefectural Cancer Center and Shibukawa Medical Center. Formal consent of patients was not required for this type of retrospective study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miura, Y., Imai, H., Sakurai, R. et al. The effect of post-progression survival on overall survival among patients with sensitive relapse of small cell lung cancer. Med Oncol 35, 45 (2018). https://doi.org/10.1007/s12032-018-1107-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-018-1107-6

Keywords

Search

Navigation