P1.07-010 Influence of Creatinine Clearance on Survival Parameters in Small Cell Lung Cancer Treated with Cisplatin-Based Chemotherapy Regimen

Abstract

Extensive stage Small Cell Lung Cancer (ES-SCLC) remains incurable with the current management strategies. Despite huge effort, only the small increment in overall survival has been achieved over the past 2 decades. Cisplatin-based combination chemotherapy regimen remains standard and provide high response rate with significant improvement in survival parameters compared to non-platin based regimen. Cisplatin dose was calculated by multiplying body surface area(BSA) and 60-100 according to chemotherapy protocol. Main excretion route for the cisplatin is kidney and the drug is contraindicated for the patients with creatinine clearance (CClr) below the 60 mL/min. In other words, decrease in CClr provide higher concentration of cisplatin and may increase therapeutic effect. Therefore, with this study, we try to explore whether creatinine clearance has significant effect on survival parameters or not for the ES-SCLC patients. A total 53 patients, 47 (88.7%) male and 6 (11.3%) female, were included. Mean age was 58 years-old (range 42-73). All patients were at good performance scale with normal renal function (CClr>60mL/min) treated with cisplatin (60-100 mg/m2/3wk)-etoposide (100 mg/m2/3wk) with. Mean cisplatin dose per cycle were 121 mg/3wks and 66 mg/m2/3wks. Objective response rate was 71.7%. During follow-up period 41 patients (77.4%) were death. Mean body surface area (BSA), CClr accounted by formula of MDRD and Cockcroft gault were 1.8 kg/m2, 116.6 and 118.2 mL/min. The statistical analysis failed to show significant correlation between cisplatin dose and BSA; between cisplatin dose and MDRD and Cockcroft gault with spearman’s correlation test (r: 0.258, n:53, p: 0.58; r: -0.211, n:53, p: 0.129; r: 0.048, n:53, p: 0.73). Median overall surviva l (OS) was 14 months (12.1-15.9, 95%CI). Statistical analysis failed to show significant effect of CClr (>120 mL/min vs <120 mL/min) on OS (p: 0.260). In this study specifically included ES-SCLC patients with excellent performance score with healthy renal function but failed to show significant effect of CClr on OS. In conclusion, calculation of cisplatin dose according to the method including CClr like the area under the curve (AUC) may not provide better survival rate in ES-SCLC.