Highlights
- •Due to limited 3rd-line therapies patients often received best supportive care only.
- •Patients left untreated (best supportive care only) live less than 1 month.
- •Median overall survival is less than 5 months for patients who did receive therapy.
- •Current therapies yield limited benefit thus new therapeutic options are needed.
Abstract
Objectives
To evaluate treatment patterns, physician-assessed overall response rate (ORR), progression-free
survival (PFS), and overall survival (OS) among third-line (3L)-plus small cell lung
cancer (SCLC) patients.
Materials and methods
Retrospective analysis of a United States (US)-based community oncology electronic
medical record (EMR) database was conducted. Target sample included SCLC patients
≥18 years of age whose disease progressed after at least 2 prior treatments. Treatment
patterns captured systemic therapy and best supportive care (BSC) in 3L, fourth-line
(4L), and fifth-line (5L) settings. ORR, PFS, and OS were evaluated for each line
of systemic therapy and OS was also evaluated for BSC.
Results
334 3L SCLC patients received systemic therapy (n = 249) or BSC (n = 85). Mean age
(standard deviation [SD]) was 63.7 (9.5), with 72% having extensive disease at initiation
of first-line therapy. Of 3L patients, 41% and 12% went on to 4L and 5L, respectively.
ORR for systemic therapy in 3L and 4L averaged around 21% while 5L was 12%. Median
PFS in 3L systemic therapy was 2.3 months (95% confidence interval [CI]: 1.9, 2.5),
which decreased in 4L and 5L. Median OS for 3L systemic therapy was 4.4 months (95%
CI: 4.0, 5.5), with 6- and 12-month survival rates of 37% and 11%, respectively. In
contrast, median OS for 3L BSC was 0.9 months (95% CI: 0.6, 1.2), with 9% survival
rate at 6 months.
Conclusion
Current treatments utilized in the 3L-plus setting yield limited survival benefit.
Furthermore, patients left untreated and placed on BSC typically live less than 1
month. New therapeutic options are thus needed for these patients, where no approved
options exist.
Abbreviations:
3L (third-line), 4L (fourth-line), 5L (fifth-line), BSC (best supportive care), CI (confidence interval), DoR (duration of response), ECOG (Eastern Cooperative Oncology Group), EMR (electronic medical record), ES (extensive-stage), FDA (Food and Drug Administration), ICD (International Classification of Diseases), IRB (institutional review board), NCCN (National Comprehensive Cancer Network), ORR (overall response rate), OS (overall survival), PFS (progression-free survival), PS (performance status), RECIST (Response Evaluation Criteria In Solid Tumors), SCLC (small cell lung cancer), SD (standard deviation), US (United States)Keywords
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Article Info
Publication History
Published online: November 08, 2018
Accepted:
November 7,
2018
Received in revised form:
November 2,
2018
Received:
July 23,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
