Prognostic Factors for Platinum-Chemotherapy Response and Survival Outcomes in Patients with Advanced Stage Non-Small Cell Lung Cancer

Abstract

The majority of patients diagnosed with non-small cell lung cancer (NSCLC) present with the disease in an advanced stage, consequently experiencing a diminished overall survival rate. The influence of patients' characteristics on their response to treatment and survival rates remains ambiguous. The current study evaluated the effect of patients’ prognostic variables on clinical outcomes of platinum-based chemotherapy in NSCLC patients. A total of seventy-five patients with stage IIIB–IV NSCLC were enrolled; baseline demographics and clinical data were collected. Patients received gemcitabine/platinum combination therapy. Response to treatment was evaluated using the RECIST Version 1.1. Patients were monitored over an 18-month period subsequent to the initiation of treatment to assess the overall survival outcomes and progression-free survival. The associations between the clinicopathological and treatment parameters and patient’s response and survival were analyzed. The current study found that poor response to treatment was associated with performance status (PS) of 2 compared to PS 0-1 (p = 0.005) and receiving carboplatin rather than cisplatin doublets (p= 0.004). Poor survival was associated with being males (p = 0.027), and having stage IV of the disease (p = 0.020). Age at diagnosis, histopathology, smoking status, family history of cancer and number of chemotherapy cycles were not associated with treatment outcomes. In conclusion, in terms of radiological response cisplatin was more effective than carboplatin and PS 0-1 was associated with better response among the study cohort. While males and stage IV disease were independently associated with shorter survival in patients with advanced stage of NSCLC receiving platinum.