1. Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line – Results from the prospective German TLK cohort study
- Author
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Corinna Elender, Claus-Christoph Steffens, Stephanie Dille, L. Spring, Norbert Marschner, Ulrich Hutzschenreuter, Martina Jänicke, and Adrian Binninger
- Subjects
Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Palliative care ,Platinum Compounds ,Carboplatin ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Germany ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Prospective Studies ,Carcinoma, Small Cell ,Lung cancer ,Etoposide ,Aged ,Neoplasm Staging ,Performance status ,business.industry ,Middle Aged ,medicine.disease ,Survival Analysis ,Confidence interval ,Clinical trial ,Treatment Outcome ,030104 developmental biology ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Female ,business ,Algorithms ,Cohort study ,medicine.drug - Abstract
Objectives Despite intensive research, the therapeutic options in extensive-stage small cell lung cancer (SCLC) are still limited. Data from routine clinical practice, so-called “real-world data”, are centrally important to assess and improve the standard of care. We present prospectively documented data on systemic first-, second- and third-line treatment, number of treatment lines and outcome parameters of patients treated by medical oncologists in Germany. Materials and methods This is a descriptive analysis on 432 patients with extensive-stage SCLC enrolled at start of first-line therapy into the prospective German clinical cohort study TLK (Tumour Registry Lung Cancer). Patients were recruited by 87 sites between February 2010 and December 2013 and followed-up individually for 3 years. Results The majority of patients (93%) received a first-line platinum-based combination therapy. Carboplatin plus etoposide was documented more frequently than cisplatin plus etoposide (46 vs. 35%); patients receiving carboplatin were older (68 vs. 63 years) and more often presented with poorer performance status (17 vs. 11% ECOG ≥ 2). Both regimens yielded similar response and survival rates. Median first-line overall survival (OS) was 10.2 months (95% confidence interval [CI] 8.6–12.3) for carboplatin plus etoposide and 12.2 months (95% CI 10.1–14.7) for cisplatin plus etoposide. Most patients (77%) would have been eligible for participation in a clinical trial. 50% of the patients received a second and 22% a third line of treatment. Median second-line OS was 5.8 months (95% CI 4.8–7.5), median third-line OS 5.7 months (95% CI 3.8–7.0). Conclusion To our knowledge, this is the first study of prospectively documented patients with extensive-stage SCLC in routine clinical practice. We present treatment algorithms as well as outcome parameters for a large cohort in first-, second- and third-line treatment. The survival times and response rates reported in this routine setting correspond to the respective measures from large prospective trials.
- Published
- 2019
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