A prognostic model for platinum-doublet as second-line chemotherapy in advanced non-small-cell lung cancer patients

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• 作者：Hongnan Mo ; Xuezhi Hao ; Yutao Liu ; Lin Wang ; Xingsheng Hu ; Jianping Xu ; Sheng Yang ; Puyuan Xing ; Youwu Shi ; Bo Jia ; Yan Wang ; Junling Li ; Hongyu Wang ; Ziping Wang ; Yan Sun and Yuankai Shi
• 刊名：Cancer Medicine
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：5
• 期：6
• 页码：1116-1124
• 全文大小：250K
• ISSN：2045-7634

文摘

Poor prognosis of advanced non-small-cell lung cancer (NSCLC) patients and the promising therapeutic effect of platinum urge the oncologists to evaluate the role of platinum doublet as second-line chemotherapy and establish the definition of platinum sensitivity in NSCLC. We retrospectively analyzed 364 advanced NSCLC patients who received platinum-doublet regimens as second-line chemotherapy after platinum-based first-line treatment. Patients were divided into four groups by their time-to-progression (TTP) after first-line chemotherapy: 0–3, 4–6, 7–12, and >12-month group, respectively. Treatment efficacy of patients' overall survival (OS), progression-free survival (PFS), and response rate (RR), as well as treatment-related toxicity, were compared among the four groups. A prognosis score system and a nomogram were established by Cox proportional hazard model, and validated by concordance index (c-index). Median OS was 14.0, 16.0, 20.0, 25.0 months for patients in the 0–3, 4–6, 7–12, >12-month group, respectively. Age ≤60 years (P = 0.002), female (P = 0.019), and TTP>12 months (P = 0.003) were independent prognostic factors. Prognostic score was calculated by adding 1 point each for any of the above three indicators, with a c-index of 0.590 (95% confidential interval [CI], 0.552–0.627). Median OS were equal to 25.0, 16.0, and 11.0 months for best (2–3 points), intermediate (1 point) and worst (0 point) category, respectively (P < 0.0001). A nomogram that integrated patient's age, gender, and TTP for OS has a c-index of 0.623 (95% CI, 0.603–0.643). Female, younger than 60 years, and TTP greater than 12 months may indicate prolonged survival after platinum-doublet second-line chemotherapy in advanced NSCLCpatients.