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Research Article|Articles in Press, 100493

Early tumor shrinkage as a predictor of favorable treatment outcomes in patients with extensive stage-small cell lung cancer who received programmed cell death-ligand 1 inhibitor plus platinum-etoposide chemotherapy: A prospective observational study

Open AccessPublished:February 28, 2023DOI:https://doi.org/10.1016/j.jtocrr.2023.100493
Early tumor shrinkage as a predictor of favorable treatment outcomes in patients with extensive stage-small cell lung cancer who received programmed cell death-ligand 1 inhibitor plus platinum-etoposide chemotherapy: A prospective observational study
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      Abstract

      Introduction

      In recent years, programmed cell death-ligand 1 (PD-L1) inhibitor plus platinum-etoposide chemotherapy has shown favorable clinical outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). The usefulness of early tumor shrinkage (ETS) has been reported in various types of cancers. However, there have been few reports evaluating ETS in ES-SCLC. Therefore, this study aimed to evaluate the role of ETS in the clinical outcomes of patients with ES-SCLC receiving chemoimmunotherapy.

      Materials and Methods

      We prospectively identified 46 patients with ES-SCLC who received PD-L1 inhibitor plus platinum-etoposide chemotherapy at 10 institutions in Japan between September 2019 and October 2021. Of them, 35 patients were selected for analyses.

      Results

      The responders (progression-free survival [PFS] ≥ 6.0 months) had significantly greater tumor shrinkage at the first evaluation than the non-responders (PFS < 6.0 months) (65.0 vs. 53.7%, p = 0.03). We defined the cut-off value for ETS as a 57% change from the baseline based on the receiver operating characteristic results to determine the optimal tumor shrinkage rate at the first evaluation for identifying responders. The patients with ES-SCLC who achieved ETS had longer PFS and overall survival (OS) than those who did not achieve ETS (5.6 vs. 4.0 months, log-rank test p = 0.001 and 15.0 vs. 8.3 months, log-rank test p = 0.02). In the multivariate analyses, ETS was significantly associated with PFS and OS (hazard ratio, 0.27; 95% confidence interval, 0.12–0.63; p = 0.002 and hazard ratio, 0.34; 95% confidence interval, 0.13–0.85; p = 0.02).

      Conclusion

      Our prospective observational study indicated that ETS was related to favorable clinical outcomes for patients with ES-SCLC receiving PD-L1 inhibitor plus platinum-etoposide chemotherapy.

      Keywords

      Article info

      Publication history

      Accepted: February 23, 2023
      Received in revised form: February 16, 2023
      Received: December 19, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      CRediT Author Contribution Statement

      Masaki Ishida, Kenji Morimoto, Tadaaki Yamada: Study conception and design.

      Masaki Ishida, Kenji Morimoto, Takayuki Takeda, Shinsuke Shiotsu, Koji Date, Taishi Harada, Nobuyo Tamiya, Yusuke Chihara, Yoshizumi Takemura, Takahiro Yamada, and Hibiki Kanda: Obtained the clinical data.

      Masaki Ishida, Kenji Morimoto, Tadaaki Yamada, Masahiro Iwasaku, Shinsaku Tokuda, Young Hak Kim, and Koichi Takayama: Data Interpretation.

      Masaki Ishida, Kenji Morimoto, Tadaaki Yamada, and Koichi Takayama: Manuscript preparation.

      The final version of the manuscript was read and approved by all the authors.

      Conflict of interest

      Tadaaki Y received grants from Pfizer, Ono Pharmaceutical, Janssen Pharmaceutical, and Takeda Pharmaceutical, and personal fees from Eli Lilly. KT received grants from Chugai Pharmaceutical and Ono Pharmaceutical, and personal fees from AstraZeneca, Chugai Pharmaceutical, MSD, Eli Lilly, Boehringer Ingelheim, and Daiichi Sankyo. The other authors have no conflicts of interest to declare.

      Identification

      DOI: https://doi.org/10.1016/j.jtocrr.2023.100493

      Copyright

      © 2023 Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer.

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