Synchronous Oligometastasis and Oligoprogression as a Prognostic Marker in Patients With Extensive-Stage SCLC Treated With a Combination of Immune-Checkpoint Inhibitor and Chemotherapy (HOT2301)

IF 3 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2024-09-07 DOI:10.1016/j.jtocrr.2024.100715

Kana Hashimoto MD , Daisuke Morinaga MD , Hajime Asahina MD, PhD , Mina Ishidoya MD , Hajime Kikuchi MD, PhD , Hiroshi Yokouchi MD, PhD , Toshiyuki Harada MD, PhD , Osamu Honjo MD , Ryota Shigaki MD , Taichi Takashina MD, PhD , Yuka Fujita MD, PhD , Mamoru Takahashi MD, PhD , Yasutaka Kawai MD , Ryotaro Kida MD , Kenichiro Ito MD , Noriaki Sukoh MD, PhD , Ayumu Takahashi MD, PhD , Fumihiro Hommura MD, PhD , Yoshihito Ohhara MD, PhD , Megumi Furuta MD, PhD , Satoshi Oizumi MD, PhD

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引用次数: 0

Abstract

Introduction

Oligometastasis and oligoprogression (OP) has not been adequately defined in extensive-stage SCLC (ES-SCLC) and may be a good indication for adding local treatment. Therefore, this multicenter study aimed to investigate the prognostic impact of oligometastasis and OP in ES-SCLC.

Methods

We enrolled patients who received chemoimmunotherapy between September 2019 and June 2022. Patients were classified into oligometastasis and non-oligometastasis groups by determining the number of original tumor lesions and distant metastases (worsening or newly appearing lesions) at the time of initial diagnosis and disease progression after first-line treatment.

Results

We retrospectively analyzed 265 consecutive patients with ES-SCLC. Synchronous oligometastasis (SOM) and OP was defined as less than or equal to five lesions in less than or equal to two organs, including lungs; 21.0% and 53.2% of patients had SOM and OP, respectively. Median progression-free survival was 5.8 months and 4.9 months in patients with and without SOM, respectively (hazard ratio [HR] = 0.72, 95% confidence interval [CI]: 0.51–1.02, p = 0.065). Median overall survival was 20.5 months and 15.0 months in patients with and without SOM (HR = 0.58, 95% CI: 0.37–0.95, p = 0.027) from the initiation of first-line treatment. The OP group revealed a better progression-free survival of 5.2 months (versus 3.2 mo, HR = 0.69, 95% CI: 0.50–0.96, p = 0.026) and overall survival of 15.1 months (versus 7.5 mo, HR = 0.44, 95% CI: 0.29–0.66, p = 0.027) from the initiation of second-line treatment compared with the non-OP group. The Lung Immune Prognostic Index score was significantly lower in the SOM and OP group.

Conclusions

ES-SCLC in patients with SOM and OP may be more indolent than that of the nonoligometastasis group, therefore, new treatment strategies, including the addition of local treatment, should be explored.

Clinical trial registration

This study was registered at UMIN-CTR (UMIN000053402).

查看原文本刊更多论文

免疫检查点抑制剂与化疗联合疗法（HOT2301）作为广泛期SCLC患者预后标志的同步寡转移和寡进展

导言寡转移和寡进展（OP）在广泛期SCLC（ES-SCLC）中尚未得到充分定义，可能是增加局部治疗的良好指征。因此，这项多中心研究旨在探讨ES-SCLC中寡转移和OP对预后的影响。方法我们纳入了2019年9月至2022年6月期间接受化疗免疫治疗的患者。结果我们回顾性分析了265例连续的ES-SCLC患者。同步少转移（SOM）和远处转移（OP）被定义为在少于或等于两个器官（包括肺部）出现少于或等于五个病灶；分别有21.0%和53.2%的患者出现SOM和OP。有SOM和无SOM患者的中位无进展生存期分别为5.8个月和4.9个月（危险比[HR] = 0.72，95%置信区间[CI]：0.51-1.02，P＜0.05）：0.51-1.02, p = 0.065).从一线治疗开始，SOM患者和非SOM患者的中位总生存期分别为20.5个月和15.0个月（HR = 0.58，95% CI：0.37-0.95，p = 0.027）。与非OP组相比，OP组的无进展生存期为5.2个月（相对于3.2个月，HR=0.69，95% CI：0.50-0.96，p=0.026），总生存期为15.1个月（相对于7.5个月，HR=0.44，95% CI：0.29-0.66，p=0.027）。结论SOM和OP组患者的ES-SCLC可能比非寡转移组患者更不活跃，因此应探索新的治疗策略，包括增加局部治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JTO Clinical and Research Reports Medicine-Oncology

CiteScore

4.20

自引率

0.00%

发文量

145

审稿时长

19 weeks