Early Tumor Shrinkage as a Predictor of Favorable Treatment Outcomes in Patients With Extensive-Stage SCLC Who Received Programmed Cell Death-Ligand 1 Inhibitor Plus Platinum-Etoposide Chemotherapy: A Prospective Observational Study

Masaki Ishida, MD; Kenji Morimoto, MD, PhD; Tadaaki Yamada, MD, PhD; Takayuki Takeda, MD, PhD; Shinsuke Shiotsu, MD, PhD; Koji Date, MD; Taishi Harada, MD; Nobuyo Tamiya, MD, PhD; Yusuke Chihara, MD, PhD; Yoshizumi Takemura, MD, PhD; Takahiro Yamada, MD, PhD; Hibiki Kanda, MD; Masahiro Iwasaku, MD, PhD; Shinsaku Tokuda, MD, PhD; Young Hak Kim, MD, PhD; Koichi Takayama, MD, PhD

JTO Clinical and Research Reports (Apr 2023)

Early Tumor Shrinkage as a Predictor of Favorable Treatment Outcomes in Patients With Extensive-Stage SCLC Who Received Programmed Cell Death-Ligand 1 Inhibitor Plus Platinum-Etoposide Chemotherapy: A Prospective Observational Study

Masaki Ishida, MD,
Kenji Morimoto, MD, PhD,
Tadaaki Yamada, MD, PhD,
Takayuki Takeda, MD, PhD,
Shinsuke Shiotsu, MD, PhD,
Koji Date, MD,
Taishi Harada, MD,
Nobuyo Tamiya, MD, PhD,
Yusuke Chihara, MD, PhD,
Yoshizumi Takemura, MD, PhD,
Takahiro Yamada, MD, PhD,
Hibiki Kanda, MD,
Masahiro Iwasaku, MD, PhD,
Shinsaku Tokuda, MD, PhD,
Young Hak Kim, MD, PhD,
Koichi Takayama, MD, PhD

Affiliations

Masaki Ishida, MD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Kenji Morimoto, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Tadaaki Yamada, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; Corresponding author. Address for correspondence: Tadaaki Yamada, MD, PhD, Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.
Takayuki Takeda, MD, PhD: Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
Shinsuke Shiotsu, MD, PhD: Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
Koji Date, MD: Department of Pulmonary Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
Taishi Harada, MD: Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan
Nobuyo Tamiya, MD, PhD: Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
Yusuke Chihara, MD, PhD: Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan
Yoshizumi Takemura, MD, PhD: Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan
Takahiro Yamada, MD, PhD: Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan
Hibiki Kanda, MD: Department of Respiratory Medicine, Omi Medical Center, Shiga, Japan
Masahiro Iwasaku, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Shinsaku Tokuda, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Young Hak Kim, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Koichi Takayama, MD, PhD: Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

Journal volume & issue: Vol. 4, no. 4
p. 100493

Abstract

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Introduction: In recent years, programmed cell death-ligand 1 (PD-L1) inhibitor plus platinum-etoposide chemotherapy was found to have favorable clinical outcomes in patients with extensive-stage SCLC (ES-SCLC). The usefulness of early tumor shrinkage (ETS) has been reported in various types of cancers. Nevertheless, 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. 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 mo) had significantly greater tumor shrinkage at the first evaluation than the nonresponders (PFS < 6.0 mo) (65.0% versus 53.7%, p = 0.03). We defined the cutoff value for ETS as a 57% change from the baseline on the basis of 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 than those who did not achieve ETS (5.6 versus 4.0 mo, log-rank test p = 0.001 and 15.0 versus 8.3 mo, log-rank test p = 0.02). In the multivariate analyses, ETS was significantly associated with PFS and overall survival (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). Conclusions: 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.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

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