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Association between chemotherapy-induced myelosuppression and curative efficacy of 2-cycle chemotherapy in small cell lung cancer

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Abstract

Background

The association of chemotherapy-induced myelosuppression with tumor response and overall survival remained controversial. The study was conducted to investigate the association between them in small cell lung cancer (SCLC).

Methods

204 eligible patients with SCLC were respectively included and categorized into three groups (no, mild, and severe myelosuppression) based on myelosuppression degree after the first chemotherapy. Curative efficacy of 2-cycle chemotherapy was evaluated by the objective response rate (ORR) and disease control rate (DCR). Univariate and multivariate logistic regression analyses were conducted to investigate their association. Receiver operator characteristic (ROC) curves, net reclassification index (NRI), and integrated discrimination improvement (IDI) were used to assess the predictive ability of myelosuppression.

Results

In the fully-adjusted model, mild (OR, 4.61; 95% CI, 1.35 to 18.27; P = 0.020) and severe (OR, 7.22; 95% CI, 1.30 to 72.44; P = 0.046) myelosuppression were positively associated with DCR. However, only mild myelosuppression was significantly associated with ORR (OR, 2.78; 95% CI, 1.30 to 6.14; P = 0.010). Although we observed evidence of increased ORR in severe myelosuppression, the difference was not statistically significant. Furthermore, based on the results of the ROC curve, NRI and IDI, chemotherapy-induced myelosuppression cannot be used as a accurate and independent predictor for curative efficacy, but it can improve overall prediction accuracy.

Conclusion

Chemotherapy-induced myelosuppression was significantly associated with curative efficacy of 2-cycle chemotherapy in SCLC, which could help predict treatment efficacy and guide chemotherapy dosage.

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Data availability

The raw data supporting the findings of this study are available upon reasonable request by contact with the corresponding author.

Abbreviations

SCLC:

Small cell lung cancer

ECOG PS:

Cooperative Oncology Group Performance Status

NCCN:

National Comprehensive Cancer Network

ORR:

Objective response rate

DCR:

Disease control rate

RECIST:

Response Evaluation Criteria in Solid Tumors

CR:

Complete response

PR:

Partial response

SD:

Stable disease

PD:

Progressive disease

OR:

Odds ratio

CI:

Confidence interval

ROC:

Receiver operator characteristic

AUC:

Area under the curve

NRI:

Net reclassification index

IDI:

Integrated discrimination improvement

DNA:

Deoxyribonucleic acid

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Funding

This work was sponsored by the General Project of Jiangsu Provincial Health Commission (No. H2019029), the Jiangsu Province Six One Project (No. LGY2018054), the “Six talent peaks” high-level talents level B (No. WSN-015), and the 333 High-level personnel Training Program.

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Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Xinyu Wang, Shujun Gu, Jingli Wen, Lixi Zhang & Xu Qi

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  1. Xinyu Wang
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  2. Shujun Gu
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Contributions

XW: Conceptualization, Methodology, Software, Writing—Original Draft; SG: Software, Validation, Writing—Review and Editing; JW: Resources, Validation, Writing—Review and Editing; LZ: Data Curation, Writing—Review and Editing; XQ: Conceptualization, Writing—Review and Editing, Project administration, Project administration.

Corresponding author

Correspondence to Xu Qi.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships.

Studies involving animal subjects

No animal studies are presented in this manuscript.

Studies involving human subjects

The Ethics Committee of The First Affiliated Hospital of Nanjing Medical University reviewed and approved the cross-sectional study (2023-SR-365). The work described has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.

Inclusion of identifiable human data

No potentially identifiable human images or data is presented in this study.

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Wang, X., Gu, S., Wen, J. et al. Association between chemotherapy-induced myelosuppression and curative efficacy of 2-cycle chemotherapy in small cell lung cancer. Cancer Chemother Pharmacol 93, 151–159 (2024). https://doi.org/10.1007/s00280-023-04608-6

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