Journal Thoracic Oncology

Abstracts Journal of Thoracic Oncology • Volume 12 Issue S1 January 2017
Background: We conducted a retrospective study to investigate the outcome
and prognostic factors of patients with relapsed SCLC who receive second or
third line chemotherapy with paclitaxel plus gemcitabine, a regimen that is
used in our institution since a phase II trial in 2001. We reviewed the medical
records of patients with SCLC who received paclitaxel plus gemcitabine
in a ten-years period, since 2005 from 2015. Overall survival (OS) from the
initiation of this regimen was evaluated, plus characteristics of these
patients. Methods: Patients diagnosed of SCLC were selected from our lung
cancer database, and compared with our Pharmacy Department database. We
selected all patients with relapsed SCLC that received therapy with paclitaxel
plus gemcitabine (PG) at any moment of the disease. Results: The median age
of the cohort was 58 years (43–81 years). There were 69 males (83.2%) and
14 females (16.8%). 72 patients (86.7%) had a previous history of smoking.
ECOG PS at relapse was 0 in 3 (3.6%), 1 in 70 (84.3%), and 2 in 10 (12.1%)
patients. Fifty patients (60.2%) had extensive disease at baseline diagnosis,
and the remaining 33 (38.8%) had limited disease. All patients were exposed
previously to etoposide and platinum. The platinum used was cisplatin in 52
patients (60.3%) and carboplatin in 30 patients (38.7%). Previous radiation
at local tumor site was received by 38 patients (45.8%). The response was
evaluated in 78 patients. The response post2 months of PG was complete
response in 2 patients (2.5%), partial response in 29 (37.1%), stable disease
in 24 (30.7%), and progressive disease in 23 patients (30.6%). The median
number of cycles of PG received was 8 (2-28) cycles. Toxicity related cessation
of treatment was required in 12 patients (14.4%). The reason for stoppage
was Grade 3–4 toxicities in 8 patients (9.6%) and deterioration in PS in 4
patients (4.8%) The median PFS was 148 days (95% CI: 30–173.5 days) while
the median OS was 172 days (95% CI: 60–485 days). Conclusion: Paclitaxel plus
gemcitabine it is a well tolerated regimen in relapsed SCLC in the schedule we
usually use (every 2 weeks). Unless this study is retrospective, we believe that
this combination can be used nowadays in these patients, if there is no clinical
trial available.
Keywords: SCLC, chemotherapy, second line
POSTER SESSION 1 - P1.07: SCLC/NEUROENDOCRINE TUMORS
DRUG TREATMENT ALONE AND IN COMBINATION WITH RADIOTHERAPY –
MONDAY, DECEMBER 5, 2016
P1.07-010 INFLUENCE OF CREATININE CLEARANCE ON SURVIVAL
PARAMETERS IN SMALL CELL LUNG CANCER TREATED WITH
CISPLATIN-BASED CHEMOTHERAPY REGIMEN
Sedat Gözel 1 , Ahmet Sumbul 1 , Ali Murat Sedef 1 , Ayberk Besen 1 , Huseyin
Mertsoylu 1 , Celal Batmaci 2 , Fatih Kose 3
1 Baskent University, Adana/Turkey, 2 Hakkari Devlet Hastanesi, Hakkari/Turkey,
3 Medical Oncology, Baskent University, Adana/Turkey
Background: Extensive stage Small Cell Lung Cancer (ES-SCLC) remains
incurable with the current management strategies. Despite huge effort,
only the small increment in overall survival has been achieved over the past
2 decades. Cisplatin-based combination chemotherapy regimen remain
standard and provide high response rate with significant improvement in
survival parameters compared to non-platin based regimen. Cisplatin dose
was calculated by multiplying body surface area(BSA) and 60-100 according
to chemotherapy protocol. Main excretion route for the cisplatin is kidney
and the drug is contraindicated for the patients with creatinine clearance
(CClr) below the 60 mL/min. In other words, decrease in CClr provide higher
concentration of cisplatin and may increase therapeutic effect. Therefore,
with this study, we try to explore whether creatinine clearance has significant
effect on survival parameters or not for the ES-SCLC patients. Methods: A
total 53 patients, 47 (88.7%) male and 6 (11.3%) female, were included. Mean
age was 58 years-old (range 42-73). All patients were at good performance
scale with normal renal function (CClr>60mL/min) treated with cisplatin
(60-100 mg/m2/3wk)-etoposide (100 mg/m2/3wk) with. Mean cisplatin dose
per cycle were 121 mg/3wks and 66 mg/m2/3wks. Objective response rate
was 71.7%. During follow-up period 41 patients (77.4%) were death. Mean
body surface area(BSA), CClr accounted by formula of MDRD and Cockcroft
gault were 1.8 kg/m2, 116.6 and 118.2 mL/min. The statistical analysis failed
to show significant correlation between cisplatin dose and BSA; between
cisplatin dose and MDRD and Cockcroft gault with spearman’s correlation test
(r: 0.258, n:53, p: 0.58; r: -0.211, n:53, p: 0.129; r: 0.048, n:53, p: 0.73). Median
overall survival(OS) was 14 months (12.1-15.9, 95%CI). Statistical analysis
failed to show significant effect of CClr (>120 mL/min vs