title: Is second-line systemic chemotherapy beneficial in patients with non-small cell lung cancer (NSCLC)? A multicenter data evaluation by the Anatolian Society of Medical Oncology.
abstract: Patients with advanced non-small cell lung cancer (NSCLC) generally require second-line treatment although their prognosis is poor. In this multicenter study, we aimed to detect the characteristics related to patients and disease that can predict the response to second-line treatments in advanced NSCLC. Data of 904 patients who have progressed after receiving first-line platinum-based chemotherapy in 11 centers with the diagnosis of stage IIIB and IV NSCLC and who were evaluated for second-line treatment were retrospectively analyzed. The role of different factors in determining the benefit of second-line treatment was analyzed. Median age of patients was 57 years (range 19-86). Docetaxel was the most commonly used (20.9 %, n = 189) single agent, while gemcitabine-platinum was the most commonly used (6.7 %, n = 61) combination chemotherapy regimen in second-line setting. According to survival analysis, median progression-free survival after first-line treatment (PFS2) was 3.5 months (standard error (SE) 0.2; 95 % confidence interval (CI), 3.2-3.9), median overall survival (OS) was 6.7 months (SE 0.3; 95 % CI, 6.0-7.3). In multivariate analysis, independent factors affecting PFS2 were found to be hemoglobin (Hb) level over 12 g/dl and treatment-free interval (TFI) longer than 3 months (p = 0.006 and 0.003, respectively). Similarly, in OS analysis, Hb level over 12 g/dl and time elapsed after the first-line treatment that is longer than 3 months were found to be independent prognostic factors (p = 0.0001 and 0.045, respectively). In light of these findings, determining and using the parameters for which the treatment will be beneficial prior to second-line treatment can increase success rate.
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Odabas
authors.affiliation: Department of Medical Oncology, Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey.
authors.forename: Arife
authors.initials: A
authors.lastname: Ulas
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Kubra
authors.initials: K
authors.lastname: Aydin
authors.affiliation: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors.forename: Mevlude
authors.initials: M
authors.lastname: Inanc
authors.affiliation: Department of Medical Oncology, Inonu University Faculty of Medicine, Malatya, Turkey.
authors.forename: Asude
authors.initials: A
authors.lastname: Aksoy
authors.affiliation: Department of Medical Oncology, Konya Education and Research Hospital, Konya, Turkey.
authors.forename: Dogan
authors.initials: D
authors.lastname: Yazilitas
authors.affiliation: Department of Medical Oncology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Turkeli
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sinemis
authors.initials: S
authors.lastname: Yuksel
authors.affiliation: Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Inal
authors.affiliation: Department of Medical Oncology, Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey.
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Ekinci
authors.affiliation: Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Sevinc
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Nebi S
authors.initials: NS
authors.lastname: Demirci
authors.affiliation: Department of Medical Oncology, Kocatepe University Faculty of Medicine, Afyon, Turkey.
authors.forename: Mukremin
authors.initials: M
authors.lastname: Uysal
authors.affiliation: Department of Medical Oncology, Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Alkis
authors.affiliation: Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.affiliation: Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aliustaoglu
authors.affiliation: Department of Medical Oncology, Bezmialem Vakif University School of Medicine, Adnan Menderes Bulvari Fatih, Istanbul, Turkey. mgumus@superonline.com.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D006454:Hemoglobins; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D002945:Cisplatin; D000093542:Gemcitabine
keywords: Hemoglobin level; Non-small cell lung cancer; Prognostic factors; Second-line treatment; Survival