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Prospective Observational Study Evaluating the Prognostic Value of the G8 Screening Tool for Extensive-Stage Small Cell Lung Cancer Patients Who Received Programmed Death-Ligand 1 Inhibitor plus Platinum–Etoposide Chemotherapy

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Abstract

Background

Programmed death-ligand 1 (PD-L1) inhibitor plus platinum–etoposide chemotherapy is used as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC), regardless of age.

Objective

We examined the role of the Geriatric 8 (G8) screening tool for evaluating treatment outcomes in patients with ES-SCLC treated with PD-L1 inhibitor plus platinum–etoposide chemotherapy as first-line therapy.

Patients and Methods

Between September 2019 and October 2021, we prospectively evaluated patients with ES-SCLC treated with immunochemotherapy at ten institutions in Japan. The G8 score was assessed before treatment initiation.

Results

We evaluated 44 patients with ES-SCLC. Patients with G8 score > 11 had longer overall survival (OS) than those with G8 score ≤ 11 (not reached versus 8.3 months; log-rank test, p = 0.005). In univariate and multivariate analyses, G8 score > 11 [hazard ratio (HR) 0.34; 95% confidence interval (CI) 0.15–0.75; p = 0.008 and HR 0.34; 95% CI 0.14–0.82; p = 0.02, respectively) and performance status (PS) of 2 (HR 5.42; 95% CI 2.08–14.2; p < 0.001 and HR 6.94; 95% CI 2.25–21.4; p < 0.001, respectively) were independent prognostic factors for OS. Among patients with good PS (0 or 1), the OS in patients with G8 score > 11 was significantly longer than that in patients with G8 score ≤ 11 (not reached versus 12.3 months; log-rank test, p = 0.02).

Conclusions

G8 score evaluation before treatment initiation was useful as a prognostic factor for ES-SCLC patients who received PD-L1 inhibitors and platinum–etoposide chemotherapy, even with good PS.

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Acknowledgments

We thank the patients, their families, and all the investigators involved in this study. Additionally, we thank Editage (www.editage.jp) for their help with the English language editing.

Author information

Authors and Affiliations

  1. Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan

    Kenji Morimoto, Tadaaki Yamada, Masaki Ishida, Akihiro Yoshimura, Masahiro Iwasaku, Shinsaku Tokuda, Young Hak Kim & Koichi Takayama

  2. Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan

    Takayuki Takeda

  3. Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan

    Shinsuke Shiotsu

  4. Department of Pulmonary Medicine, Kyoto Chubu Medical Center, Kyoto, Japan

    Koji Date

  5. Department of Medical Oncology, Fukuchiyama City Hospital, Kyoto, Japan

    Taishi Harada

  6. Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan

    Nobuyo Tamiya

  7. Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan

    Yusuke Chihara

  8. Department of Pulmonary Medicine, Otsu City Hospital, Shiga, Japan

    Yoshizumi Takemura

  9. Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan

    Takahiro Yamada

  10. Department of Respiratory Medicine, Omi Medical Center, Shiga, Japan

    Hibiki Kanda

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  1. Kenji Morimoto
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Corresponding author

Correspondence to Tadaaki Yamada.

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Funding

Not applicable.

Conflicts of Interest

Tadaaki Y received grants from Pfizer, Ono Pharmaceutical, Janssen Pharmaceutical, and Takeda Pharmaceutical and personal fees from Eli Lilly. KT received grants from Chugai Pharmaceutical and Ono Pharmaceutical, and personal fees from AstraZeneca, Chugai Pharmaceutical, MSD, Eli Lilly, Boehringer Ingelheim, and Daiichi Sankyo. The other authors have no conflicts of interest to declare.

Ethical Approval

This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013), and the study protocol was approved by the institutional review board of Kyoto Prefectural University of Medicine (ERB-C-1580), and each participating hospital and was registered at the University Medical Hospital Information Network (UMIN) Clinical Trials Registry (UMIN000044048).

Consent to Participate

All patients provided written informed consent.

Consent for Publication

Not applicable

Data Availability Statement

The datasets generated during the current study are not publicly available because of ethical constraints but are available from the corresponding author upon reasonable request.

Code Availability

Not applicable

Authors Contributions

KM and Tadaaki Y contributed to the study conception and design. KM, TT, SS, KD, TH, NT, YC, YT, Takahiro Y, HK, and Masaki I obtained the clinical data. Data were interpreted by KM, Tadaaki Y, Masaki I, AY, Masahiro I, ST, YHK, and KT. The manuscript was prepared by KM, Tadaaki Y, and KT. The final version of the manuscript was read and approved by all the authors.

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Morimoto, K., Yamada, T., Takeda, T. et al. Prospective Observational Study Evaluating the Prognostic Value of the G8 Screening Tool for Extensive-Stage Small Cell Lung Cancer Patients Who Received Programmed Death-Ligand 1 Inhibitor plus Platinum–Etoposide Chemotherapy. Drugs Aging 40, 563–571 (2023). https://doi.org/10.1007/s40266-023-01034-4

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