Clinical Model to Predict Survival in Chemonaive Patients With Advanced Non-Small-Cell Lung Cancer Treated With Third-Generation Chemotherapy Regimens Based on Eastern Cooperative Oncology Group Data

Harvard University, Cambridge, Massachusetts, United States
Journal of Clinical Oncology (Impact Factor: 18.43). 02/2005; 23(1):175-83. DOI: 10.1200/JCO.2005.04.177
Source: PubMed


(1) Identify clinical factors that can be used to predict survival in chemotherapy-naive patients with advanced non-small-cell lung cancer (NSCLC) treated with third-generation chemotherapy regimens, and (2) build a clinical model to predict survival in this patient population.
Using data from two randomized, phase III Eastern Cooperative Oncology Group (ECOG) trials (E5592/E1594), we performed univariate and multivariate stepwise Cox regression analyses to identify survival prognostic factors. We used 75% of randomly sampled data to build a prediction model for survival, and the remaining 25% of data to validate the model.
From 1993 to 1999, 1,436 patients with stage IV or IIIB NSCLC with effusion were treated with platinum-based doublets (involving either paclitaxel, docetaxel, or gemcitabine). The response rate and median survival time were 20% and 8.2 months, respectively. One- and 2-year survivals were 33% and 11%, respectively. In multivariate analysis, six independent poor prognostic factors were identified: skin metastasis (hazard ratio [HR], 1.88), lower performance status (ECOG 1 or 2; HR, 1.46), loss of appetite (HR, 1.62), liver metastasis (HR, 1.32), >/= four metastatic sites (HR, 1.20), and no prior surgery (HR, 1.16). A nomogram using six pretreatment prognostic factors was built to predict 1- and 2-year survival.
Six pretreatment factors can be used to predict survival in chemotherapy-naive NSCLC patients treated with standard chemotherapy. Using our prognostic nomogram, 1- and 2-year survival probability of NSCLC patients can be estimated before treatment. This prognostic model may help clinicians and patients in clinical decision making, as well as investigators in research planning.

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    • "Unfortunately, of all patients with NSCLC 15% survive five years. Age, sex, histological type, stage, performance status, some genetic mutations and smoking are known as common prognostic factors (Hoang et al., 2005; Riquet et al., 2007; Albain et al., 2009; Caglar et al., 2009; Alimujiang et al., 2013; Kamsa-Ard et al., 2013; Pan et al., 2013). Some epidemiological studies evaluated whether epidemiologic properties had an effect on mortality or morbidity of cancer (Mutlu et al., 2011; 2013; Fuhrman et al., 2013; Holick et al., 2013). "
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    Asian Pacific journal of cancer prevention: APJCP 11/2013; 14(11):6301-4. DOI:10.7314/APJCP.2013.14.11.6301 · 2.51 Impact Factor
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    • "The traditional evaluation of prognosis in non-small cell lung carcinoma (NSCLC) has relied, as in most other malignant tumors, on the stage of disease at the time of clinical presentation. Other factors currently commonly considered include performance status, weight loss, and presence or absence of symptoms at diagnosis, as well as time-honored pathologic parameters, eg, tumor size, tumor differentiation, and histologic subtype.3 However, advances in molecular biology have provided important insights into other potentially significant prognostic biomarkers during the last decade.4 "
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    • "Metastatic non-small-cell lung cancer (NSCLC) is currently considered an incurable disease; median overall survival is 12 months with platinum-based chemotherapy [1,2] and only 3.5% of patients survive five years after diagnosis [3]. Therapies targeting EGFR mutations have revolutionized the treatment of NSCLC; however, additional targeted therapies are lacking. "
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