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.

Abstract

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. 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. 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. 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 8.3months; 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 12.3months; log-rank test, p=0.02). 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.