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Respiratory investigation
Mar 17, 2025;63 (3): 373-382.

Prognostic impact of oligometastasis in older patients with extensive-stage small cell lung cancer.

Daisuke Morinaga, Kana Hashimoto, Hajime Asahina, Hisashi Tanaka, Osamu Honjo, Toshiyuki Harada, Hiroshi Yokouchi, Hajime Kikuchi, Ryota Shigaki, Taichi Takashina, Keiichi Nakamura, Yasutaka Kawai, Mamoru Takahashi, Ryotaro Kida, Noriaki Sukoh, Kenichiro Ito, Ayumu Takahashi, Hirofumi Hommura, Yoshihito Ohhara, Megumi Furuta, Satoshi Konno, Yukio Hosomi, Satoshi Oizumi
Author Information
  1. Daisuke Morinaga: Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan. Electronic address: d.morinaga@pop.med.hokudai.ac.jp.
  2. Kana Hashimoto: Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Bunkyo-ku, Tokyo, 113-8677, Japan.
  3. Hajime Asahina: Department of Respiratory Medicine, NHO Hokkaido Cancer Center, 2-3-54 Kikusui 4, Shiroishi-ku, Sapporo, 003-0804, Japan. Electronic address: asahinah@pop.med.hokudai.ac.jp.
  4. Hisashi Tanaka: Department of Respiratory Medicine, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan.
  5. Osamu Honjo: Department of Respiratory Medicine, Sapporo Minami-Sanjo Hospital, 4-2, South 6, West 3, Chuou-ku, Sapporo, 060-0063, Japan.
  6. Toshiyuki Harada: Department of Respiratory Medicine, JCHO Hokkaido Hospital, 1-8-3-18, Nakanoshima, Toyohira-ku, Sapporo, 062-0921, Japan.
  7. Hiroshi Yokouchi: Department of Respiratory Medicine, NHO Hokkaido Cancer Center, 2-3-54 Kikusui 4, Shiroishi-ku, Sapporo, 003-0804, Japan.
  8. Hajime Kikuchi: Department of Respiratory Medicine, Obihiro-Kosei General Hospital, West 15, South 10, Obihiro, 080-0024, Japan.
  9. Ryota Shigaki: Department of Internal Medicine, Division of Respiratory Medicine and Neurology, Asahikawa Medical University, 2-1-1-1, Midorigaoka-Highashi, Asahikawa, 078-8510, Japan.
  10. Taichi Takashina: Department of Respiratory Medicine, Iwamizawa Municipal General Hospital, 9jo, West 7, Iwamizawa, 068-8555, Japan.
  11. Keiichi Nakamura: Department of Respiratory Medicine, NHO Asahikawa Medical Center, 7-4048, Hanasaki-cho, Asahikawa, 070-8644, Japan.
  12. Yasutaka Kawai: Department of Respiratory Medicine, Oji General Hospital, 3-4-8, Wakakusa-cho, Tomakomai, 053-0021, Japan.
  13. Mamoru Takahashi: Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, West 16, South 1, Chuou-ku, Sapporo, 060-8543, Japan.
  14. Ryotaro Kida: Department of Respiratory Medicine, Hokkaido Prefectural Kitami Hospital, 2-1, East 2, North 7, Kitami, 090-0027, Japan.
  15. Noriaki Sukoh: Department of Respiratory Medicine, NHO Hokkaido Medical Center, 5-7-1-1, Nishi-ku, Sapporo, 063-0005, Japan.
  16. Kenichiro Ito: Department of Respiratory Medicine, KKR Sapporo Medical Center, 1-6-3-40, Hiragishi, Toyohira-ku, Sapporo, 062-0931, Japan.
  17. Ayumu Takahashi: Department of Medicine, Hokkaido Chuo Rosai Hospital, Japan Organization of Occupational Health and Safety, 4-16-5, Iwamizawa, 068-0004, Japan.
  18. Hirofumi Hommura: Department of Respiratory Medicine, Sapporo City General Hospital, 1-1, West 13, North 11, Chuou-ku, Sapporo, 060-8604, Japan.
  19. Yoshihito Ohhara: Department of Medical Oncology, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
  20. Megumi Furuta: Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
  21. Satoshi Konno: Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
  22. Yukio Hosomi: Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Bunkyo-ku, Tokyo, 113-8677, Japan.
  23. Satoshi Oizumi: Department of Respiratory Medicine, NHO Hokkaido Cancer Center, 2-3-54 Kikusui 4, Shiroishi-ku, Sapporo, 003-0804, Japan.
PMID: 40107221 DOI: 10.1016/j.resinv.2025.03.008

Abstract

BACKGROUND: Immune checkpoint inhibitor plus chemotherapy (ICT) is the standard treatment for extensive-stage small cell lung cancer (ES-SCLC). We previously reported that oligometastasis (OM) is a predictor of ICT efficacy, however, the relationship between ICT efficacy and OM in older patients remains unknown. Therefore, this study examined the efficacy of ICT in the older patients including the influence of OM.
METHODS: We enrolled patients with ES-SCLC who received ICT as first-line treatment between September 2019 and June 2022. Patient characteristics and treatment efficacy were compared between older (���75 years) and non-older (<75 years) patients.
RESULTS: We enrolled 228 patients, including 42 older patients. The prevalence of synchronous oligometastasis (SOM) at the start of first-line treatment was 21.0 % and 21.4 % (p = 1.0) in the older and non-older groups, respectively. The progression-free survival (PFS) with first-line therapy was 5.4 and 4.5 months (p = 0.55) and overall survival (OS) was 11.5 and 12.6 months (p = 0.74) for the SOM and non-SOM subgroups in the older group, respectively. For second-line treatment, PFS was 4.5 and 6.3 months (p = 0.79), and OS after second-line initiation was 16.0 and 13.2 months (p = 0.55) in oligoprogression (OP) and non-OP patients in the older group, respectively.
CONCLUSIONS: The frequencies of SOM and OP were not significantly different between older and non-older patients. Although the small number of older patients in this study makes it impossible to conclude definitively, we did not observe a significant prognostic prolongation in older patients with OM as in non-older patients.

Keywords

Combination therapy Extensive-stage small cell lung cancer Immune checkpoint inhibitor Older patients Oligometastasis
Journal Article
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Word Cloud

Created with Highcharts 10.0.0patientsolderICTtreatmentsmallOMefficacynon-older45monthsp = 0celllungcanceroligometastasisfirst-lineSOM0respectivelyImmunecheckpointinhibitorextensive-stageES-SCLCstudyincludingenrolledyears21%survivalPFStherapy55OS6groupsecond-lineOPBACKGROUND:pluschemotherapystandardpreviouslyreportedpredictorhoweverrelationshipremainsunknownThereforeexaminedinfluenceMETHODS:receivedSeptember2019June2022Patientcharacteristicscompared���75<75RESULTS:22842prevalencesynchronousstartp = 1groupsprogression-freeoverall111274non-SOMsubgroups379initiation16132oligoprogressionnon-OPCONCLUSIONS:frequenciessignificantlydifferentAlthoughnumbermakesimpossibleconcludedefinitivelyobservesignificantprognosticprolongationPrognosticimpactCombinationExtensive-stageOlderOligometastasis

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