Real-world outcomes of chemotherapy for lung cancer patients undergoing hemodialysis: A multicenter retrospective cohort study (NEJ-042)
Menée au Japon dans un contexte de vie réelle à partir de données portant sur 162 patients atteints d'un cancer du poumon diagnostiqué entre 2002 et 2018 et hémodialysés, cette étude de cohorte rétrospective analyse l'efficacité, du point de vue du taux de réponse objective et de la survie globale, et la toxicité d'une chimiothérapie
Introduction : Malignant tumors are the major cause of death in hemodialysis patients. Managementof these patients remains challenging as there is no evidence that chemotherapy isbeneficial, and a lack of information about actual clinical practice. Methods : This multicenter retrospective study included hemodialysis patients who were diagnosed with lung cancer from January 2002 to June 2018. We reviewed their clinical informationincluding patient characteristics associated with lung cancer and end-stage renaldisease, regimen, efficacy and safety of chemotherapy, and outcomes. Results : A total of 162 patients from 22 institutions in Japan were registered. Of 158 eligiblepatients, 91 received chemotherapy (80 as palliative chemotherapy and 11 as chemoradiotherapy)and 67 received best supportive care only regardless of cancer stage. In small celllung cancer (SCLC) and non-small cell lung cancer (NSCLC) patients who received cytotoxicchemotherapy, the objective response rates (ORR) and median overall survival (OS)were 68.1%, 12.3 months and 37.0%, 8.5 months, respectively. The ORR and median OSin patients with EGFR-mutant NSCLC treated with EGFR-tyrosine kinase inhibitors (TKI)were 44.4% and 38.6 months. The treatment-related adverse events (Grade 3 or higher)induced by cytotoxic chemotherapy were myelosuppression and febrile neutropenia; treatment-relateddeath (TRD) was observed in one patient. TRD occurred in 3 of 18 patients who receivedEGFR-TKI. Conclusion : Chemotherapy should be considered for hemodialysis patients with EGFR-mutant NSCLCand SCLC. However, the survival benefits of chemotherapy for NSCLC patients with EGFR-wildtype are unclear; physicians should carefully consider whether to offer chemotherapyto this patient subset.
Lung Cancer 2022