Influence of histological type, smoking history and chemotherapy on survival after first-line therapy in patients with advanced non-small cell lung cancer.

Full Abstract

The usual primary endpoint in clinical trials for first-line chemotherapy in advanced non-small cell lung cancer is overall survival. Second-line chemotherapy can also prolong overall survival. Non-smoking history has been associated with a treatment effect for epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) versus placebo for overall survival. We performed a retrospective analysis to identify prognostic factors for progression-free survival and overall survival in patients with advanced non-small cell lung cancer treated with first-line carboplatin/paclitaxel, and to examine the effect of second-line therapy on progression-free survival and overall survival. Ninety-eight patients (median age 61 years, 35 female, 74 adenocarcinoma, 68 smokers, 56 performance status 0) fulfilled our criteria, of which 75 patients (78%) received more than second-line therapy (docetaxel [54%] gefitinib [48%] erlotinib [4%]). For overall survival, smoking history and histology were significant prognostic factors. The 2-year overall survival rates were as follows:
smokers, 17%; non-smokers, 52%, P < 0.0001; adenocarcinoma, 40%; other 15%, P = 0.0017. Multivariate analysis in patients who received second-line therapy showed treatment with EGFR-TKI was an independent predictor of overall survival. Smoking history and adenocarcinoma histology were prognostic factors for an improved outcome with carboplatin/paclitaxel in patients with non-small cell lung cancer. Our study results suggest that the use of EGFR-TKI after first-line treatment may be associated with an improvement in overall survival.

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Author information

Author/s: Itaya, Toru (T); Yamaoto, Nobuyuki (N); Ando, Masahiko (M); Ebisawa, Masako (M); Nakamura, Yukiko (Y); Murakami, Haruyasu (H); Asai, Gyo (G); Endo, Masahiro (M); Takahashi, Toshiaki (T);

Affiliation: Thoracic Oncology Division, Shizuoka Cancer center, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.

Journal and publication information

Publication Type: Journal Article

Journal: Cancer science (Cancer Sci), published in England. (Language: eng)

Reference: 2007-Feb; vol 98 (issue 2) : pp 226-30

Dates: Created 2007/01/19; Completed 2007/02/23;

PMID: 17233840, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Carcinoma, Non-Small-Cell Lung - classification; drug therapy; pathology
Disease Progression
Female
Humans
Lung Neoplasms - classification; drug therapy; pathology

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