Predictive and prognostic factors in small cell lung carcinoma (SCLC)--analysis from routine clinical practice.
BACKGROUND
Prognostic and predictive factors of routine clinical practice among patients with small cell lung carcinoma (SCLC) were evaluated.


METHODS
Data from 106 patients with SCLC treated by first-line adriamycin, cyclophosphamide and etoposide (ACE) chemotherapy were analyzed. Multivariate analysis was performed.


RESULTS
The median overall survival (mOS) of patients was 9.36 months with mOS of 31%, 8% and 3% after 1, 2 and 5 years, respectively. Using multivariate analysis ECOG performance status (p =0.008) and white blood count (WBC) (p=0.022) were independent prognostic factors for mOS. With both, three groups of outcome (good, intermediate, poor) resulting in mOS of 15.8 months, 6.87 months and 3.35 months (p<0.0001) could be established, respectively. The absence of brain metastases (p=0.002), dose reduction (p=0.002) and LDH value (p=0.017) were independent predictive markers. Additionally, female gender was predictive (p=0.025) for complete response (CR).


CONCLUSIONS
Patients with a poor prediction profil might not benefit from ACE chemotherapy. As a consequence, prognostic/predictive factors should be included as stratification criteria in prospective clinical studies.
Brueckl
Wolfgang M
WM
Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany. wolfgang.brueckl@med1.imed.unierlangen.de
Herbst
Lara
L
Lechler
Annette
A
Fuchs
Florian
F
Schoeberl
Anja
A
Zirlik
Sabine
S
Klein
Peter
P
Brunner
Thomas B
TB
Papadopoulos
Thomas
T
Hohenberger
Werner
W
Hahn
Eckhart G
EG
Wiest
Gunther H
GH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide