scholarly journals Initial treatment and survival in Danish patients diagnosed with non-small-cell lung cancer (2005–2015): SCAN-LEAF study

2021 ◽  
Author(s):  
Jens Benn Sørensen ◽  
Pia Horvat ◽  
Mats Rosenlund ◽  
Anne Mette Kejs ◽  
Dony Patel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Initial Treatment ◽  
Kinase Inhibitor ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Curative Radiotherapy ◽  
Stage Iv Disease

Aim: To describe initial treatment patterns and survival of patients diagnosed with non-small-cell lung cancer (NSCLC) in Denmark, before immune checkpoint inhibitor and later-generation tyrosine kinase inhibitor use. Patients & methods: Adults diagnosed with incident NSCLC (2005–2015; follow-up: 2016). Initial treatments and overall survival (OS) are reported. Results: 31,939 NSCLC patients (51.6% stage IV) were included. Increasing use of curative radiotherapy/chemoradiation for stage I, II/IIIA and IIIB NSCLC coincided with improved 2-year OS. Systemic anticancer therapy use increased for patients with stage IV non-squamous NSCLC (53.0–60.6%) but not squamous NSCLC (44.9–47.3%). 1-year OS improved in patients with stage IV non-squamous NSCLC (23–31%) but not squamous NSCLC (22–25%). Conclusion: Trends indicated improved OS as treatments evolved between 2005 and 2015, but the effect was limited to 1-year OS in stage IV disease.

Multitargeted Antifolate LY231514 as First-Line Chemotherapy for Patients With Advanced Non–Small-Cell Lung Cancer: A Phase II Study

1999 ◽  
Vol 17 (4) ◽  
pp. 1194-1194 ◽  
Author(s):  
James J. Rusthoven ◽  
Elizabeth Eisenhauer ◽  
Charles Butts ◽  
Richard Gregg ◽  
Janet Dancey ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Stage Iv ◽  
Small Cell ◽  
Stage Iiib ◽  
Small Cell Lung ◽  
Stage Iv Disease ◽  
Grade 3

PURPOSE: To evaluate the efficacy and safety of the multitargeted antifolate LY231514 (MTA) in patients receiving initial chemotherapy for unresectable, advanced non–small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with measurable, advanced NSCLC who had not received previous chemotherapy for advanced disease were considered for this study. Eligible patients who gave written informed consent initially received MTA 600 mg/m2 intravenously (IV) for 10 minutes every 3 weeks. After three patients received treatment at this dose, the dose was reduced to 500 mg/m2 IV at the same infusion time and frequency because of toxicity seen in this study and another Canadian MTA trial in colorectal cancer. Patients received up to four cycles after complete or partial remission or six cycles after stable disease was documented. RESULTS: Thirty-three patients were accrued onto the study. All were assessable for toxicity, and 30 patients were assessable for response. All but one patient had an Eastern Cooperative Oncology Group performance status score of 0 or 1, 18 patients (55%) had adenocarcinoma, and nine patients (27%) had squamous cell carcinoma. Twenty-five patients (76%) had stage IV disease, and the remainder had stage IIIB disease at trial entry. Seven patients experienced a confirmed partial response and no complete responses were seen; thus, the overall response rate was 23.3% (95% confidence interval, 9.9% to 42.3%). The median duration of response was 3.1 months (range, 2.3 to 13.5 months) after a median follow-up period of 7.9 months. Four (67%) of six patients with stage IIIB disease and three (12.5%) of 24 with stage IV disease responded to treatment. Four patients (13.3%) experienced febrile neutropenia and 13 (39%) experienced grade 3 or 4 neutropenia, whereas only one patient (3%) developed grade 4 thrombocytopenia. Nonhematologic toxicity was generally mild or moderate, but 39% of patients developed a grade 3 skin rash. Most other toxicities comprised grade 1 or 2 stomatitis, diarrhea, lethargy, and anorexia. Ten patients stopped protocol therapy because of toxicity. CONCLUSION: MTA seems to have clinically meaningful activity as a single agent against advanced NSCLC. Toxicity is generally mild and tolerable. Further study of this agent in combination with cisplatin and other active drugs is warranted in this disease.

Carboplatin and Etoposide in an Out-Patient Schedule for the Palliation of Advanced Non-Small-Cell Lung Cancer

1995 ◽  
Vol 81 (6) ◽  
pp. 429-431 ◽  
Author(s):  
Enrico Aitini ◽  
Giovanna Cavazzini ◽  
Maurizio Cantore ◽  
Carla Rabbi ◽  
Riccardo Malaspina ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Iv Disease ◽  
Advanced Stages ◽  
Disease Free

Aims and background In Western countries, non-small-cell lung cancer is the most important cause of cancer-related death. To date, medical treatment for advanced stages remains of a palliative nature. Methods Forty-four patients with advanced non-small-cell lung cancer were treated in a phase II study with carboplatin and etoposide (each at 60 mg/m2 daily) in a 5-day schedule. Among 44 patients, 18 (40%) had stage IIIB disease and 26 (60%) had stage IV disease. Results Treatment was well tolerated, and the only significant side effect was alopecia. The overall response rate was 27% with 2 complete remissions; median survival time was 10.4 months. One of the 2 patients achieving a complete remission was still alive and disease free at 36 months from the start of therapy. An improvement of performance status was observed in 22 patients (50%). Conclusions The combination of carboplatin and etoposide using this schedule appears to be well tolerated and has some activity in the palliation of advanced non-small-cell lung cancer.

scholarly journals Treatment beyond four cycles of first line Platinum and Etoposide chemotherapy in real-life patients with stage IV Small Cell Lung Cancer: a retrospective study of the Merseyside and Cheshire Cancer network

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mostafa Sallam ◽  
Helen Wong ◽  
Carles Escriu
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Clinical Benefit ◽  
Real Life ◽  
Stage Iv ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Stage Iv Disease

Abstract Background Dose intensity and dose density of first line Platinum and Etoposide (PE) do not influence Overall Survival (OS) of Small Cell Lung Cancer (SCLC) patients. The effect of treatment length, however, remains unclear. Current guidelines recommend treating beyond 4 cycles -up to 6-, in patients that respond to and tolerate systemic treatment. This has led to variable practice both in clinical practice and clinical research. Here we aimed at quantifying the possible clinical benefit of the extended regimen in our real-life patients treated with PE doublet. Methods Of all patients with SCLC treated in our network with non-concurrent first line PE chemotherapy between 2008 and 2015, we identified and described patients that received 4 cycles (4c) or more (> 4c), and analysed patients with stage IV disease. Results Two hundred forty-one patients with stage IV had 4c and 69 had > 4c. The latter were more likely to have sequential thoracic radiotherapy, which suggested a lower metastatic burden. Nevertheless, there were no statistically significant differences when comparing clinical outcomes. The median Duration of Response (DoR; time from last chemotherapy cycle to progression) was 5 months in both groups (HR 1.22; 95% CI 0.93–1.61). Median Progression Free Survival (PFS; time from diagnosis to radiological progression) was 8 months (4c) versus 9 months (> 4c) (HR 0.86; 95% CI 0.66–1.13) and median OS was 11 versus 12 months (HR 0.86, 95% CI 0.66–1.14). Conclusion Our results highlight a lack of clinical benefit by extending first line PE treatment in stage IV disease, and support limiting treatment to 4 cycles until superiority of a longer regimen is identified in a randomised study.

Trends in stage distribution for patients with non-small cell lung cancer: A National Cancer Database Survey

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7598-7598 ◽  
Author(s):  
D. Morgensztern ◽  
B. Goodgame ◽  
P. Chitneni ◽  
M. Q. Baggstrom ◽  
F. Gao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Stage Iv ◽  
Small Cell ◽  
National Cancer Database ◽  
Small Cell Lung ◽  
Stage Distribution ◽  
Stage Iv Disease ◽  
Significant Change

7598 Background: We have previously reported a significant change in stage distribution for non-small cell lung cancer (NSCLC) among patients diagnosed at our institution (ASCO 2006 # 7205). To confirm this observation, a larger sample population was evaluated. Methods: Patients with NSCLC registered at the National Cancer Database (NCDB) and diagnosed between the years 1998 and 2003 were evaluated for demographic characteristics including age, race, gender, and stage at presentation. Results: 551,248 patients were identified. Patients with stage 0 or unknown stage were excluded from the study, leaving 510,942 eligible for the final analysis. The annual proportions of stage IV disease at the time of diagnosis are described in the table below. Stage distribution remained stable from 1998 to 2000, but a sharp increase in the percentage of stage IV was noticed between 2000 and 2001 (35.7% to 38.9%). This increase in the percentage of stage IV patients was sustained in the subsequent years and present across the other demographic variables. Conclusions: We have documented a significant change in the NSCLC stage distribution over the last six years. The NCDB is the largest database available and currently captures approximately 62% of all NSCLC patients diagnosed in the United States. The increase in stage IV disease coincides with the widespread adoption of FDG-PET, suggesting an earlier diagnosis of metastatic disease and confirming our previous findings. No significant financial relationships to disclose. [Table: see text]

Tirapazamine Plus Cisplatin Versus Cisplatin in Advanced Non–Small-Cell Lung Cancer: A Report of the International CATAPULT I Study Group

2000 ◽  
Vol 18 (6) ◽  
pp. 1351-1359 ◽  
Author(s):  
Joachim von Pawel ◽  
Reinhard von Roemeling ◽  
Ulrich Gatzemeier ◽  
Michael Boyer ◽  
Lars Ove Elisson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Stage Iv ◽  
Small Cell ◽  
Phase Iii ◽  
Small Cell Lung ◽  
Stage Iv Disease

PURPOSE: A phase III trial, Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non–Small-Cell Lung Tumors (CATAPULT I), was designed to determine the efficacy and safety of tirapazamine plus cisplatin for the treatment of non–small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with previously untreated NSCLC were randomized to receive either tirapazamine (390 mg/m2 infused over 2 hours) followed 1 hour later by cisplatin (75 mg/m2 over 1 hour) or 75 mg/m2 of cisplatin alone, every 3 weeks for a maximum of eight cycles. RESULTS: A total of 446 patients with NSCLC (17% with stage IIIB disease and pleural effusions; 83% with stage IV disease) were entered onto the study. Karnofsky performance status (KPS) was ≥ 60 for all patients (for 10%, KPS = 60; for 90%, KPS = 70 to 100). Sixty patients (14%) had clinically stable brain metastases. The median survival was significantly longer (34.6 v 27.7 weeks; P = .0078) and the response rate was significantly greater (27.5% v 13.7%; P < .001) for patients who received tirapazamine plus cisplatin (n = 218) than for those who received cisplatin alone (n = 219). The tirapazamine-plus-cisplatin regimen was associated with mild to moderate adverse events, including acute, reversible hearing loss, reversible, intermittent muscle cramping, diarrhea, skin rash, nausea, and vomiting. There were no incremental increases in myelosuppression, peripheral neuropathy, or renal, hepatic, or cardiac toxicity and no deaths related to tirapazamine. CONCLUSION: The CATAPULT I study shows that tirapazamine enhances the activity of cisplatin in patients with advanced NSCLC and confirms that hypoxia is an exploitable therapeutic target in human malignancies.

Non-small cell lung cancer in the new millennium: The effect of FDG-PET on stage distribution

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7205-7205 ◽  
Author(s):  
B. Goodgame ◽  
D. Morgensztern ◽  
L. Grove ◽  
R. Govindan
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Stage Iv ◽  
Small Cell ◽  
Initial Presentation ◽  
Small Cell Lung ◽  
Stage Distribution ◽  
Stage Iv Disease

7205 Background: The stage-wise distribution of NSCLC at the time of initial presentation following the widespread use of positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose (FDG-PET) has not been characterized. Frequently quoted estimates of stage distribution are based predominantly on data prior to 2000. FDG-PET was approved in 1998 and has been widely utilized since 2000. We describe here the stage-wise distribution of NSCLC at the time of initial presentation over the past 15 years. Methods: Patients were identified and clinical data were obtained through our institutional tumor registry system. All patients diagnosed with NSCLC between January 1, 1990 and December 31, 2004 were included. All statistical comparisons were performed by X2 tests. Results: Of 6311 patients identified, 3926 were diagnosed prior to January 1, 2000 and 2385 thereafter. Pathological (surgical) staging was completed in 37% of patients. Given the widespread availability of FDG-PET since 2000, we grouped the analysis by date of diagnosis, before or after January 1, 2000. Before 2000, stage proportions were: I-29%; II-9%; III-31%; IV-30%; and unknown-1%. After January 1, 2000, stage proportions were: I-26%; II-9%; III-26%; IV-37%; and unknown-2%. The percentage of stage IV disease peaked at 40% in 2004. The difference in rates of stage IV disease before and after January 1, 2000 was highly significant (p < 0.0001). Conclusions: We have documented a significant change in the distribution of stages of non-small cell lung cancer in the last five years. The increase in stage IV disease and decreases in stages I & III disease coincide with the widespread adoption of FDG-PET, suggesting an earlier diagnosis of metastatic disease. [Table: see text]

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