Prognostic factors in patients with advanced non-small cell lung cancer : data from the phase III FLEX study

Pirker, R., Pereira, J. R., Szczesna, A., von Pawel, J., Krzakowski, M., Ramlau, R., Vynnychenko, I., Park, K., Eberhardt, W. E. E., de Marinis, F., Heeger, S., Goddemeier, T., O'Byrne, Kenneth J., & Gatzemeier, U. (2012) Prognostic factors in patients with advanced non-small cell lung cancer : data from the phase III FLEX study. Lung Cancer, 77(2), pp. 376-382.

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The FLEX study demonstrated that the addition of cetuximab to chemotherapy significantly improved overall survival in the first-line treatment of patients with advanced non-small cell lung cancer (NSCLC). In the FLEX intention to treat (ITT) population, we investigated the prognostic significance of particular baseline characteristics. Individual patient data from the treatment arms of the ITT population of the FLEX study were combined. Univariable and multivariable Cox regression models were used to investigate variables with potential prognostic value. The ITT population comprised 1125 patients. In the univariable analysis, longer median survival times were apparent for females compared with males (12.7 vs 9.3 months); patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 compared with 1 compared with 2 (13.5 vs 10.6 vs 5.9 months); never smokers compared with former smokers compared with current smokers (14.6 vs 11.1 vs 9.0); Asians compared with Caucasians (19.5 vs 9.6 months); patients with adenocarcinoma compared with squamous cell carcinoma (12.4 vs 9.3 months) and those with metastases to one site compared with two sites compared with three or more sites (12.4 months vs 9.8 months vs 6.4 months). Age (<65 vs ≥65 years), tumor stage (IIIB with pleural effusion vs IV) and percentage of tumor cells expressing EGFR (<40% vs ≥40%) were not identified as possible prognostic factors in relation to survival time. In multivariable analysis, a stepwise selection procedure identified age (<65 vs ≥65 years), gender, ECOG PS, smoking status, region, tumor histology, and number of organs involved as independent factors of prognostic value. In summary, in patients with advanced NSCLC enrolled in the FLEX study, and consistent with previous analyses, particular patient and disease characteristics at baseline were shown to be independent factors of prognostic value. The FLEX study is registered with, number NCT00148798. © 2012 Elsevier Ireland Ltd.

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ID Code: 65347
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Biomarker, Cetuximab, Chemotherapy, Lung cancer, NSCLC, Prognostic factor, cisplatin, navelbine, vasculotropin, adult, advanced cancer, age, aged, article, Asian, cancer combination chemotherapy, cancer prognosis, cancer survival, Caucasian, controlled study, female, histology, human, lung adenocarcinoma, lung metastasis, lung non small cell cancer, lung squamous cell carcinoma, major clinical study, male, multiple cycle treatment, phase 3 clinical trial (topic), pleura effusion, priority journal, protein expression, race difference, sex difference, smoking, survival time, Aged, 80 and over, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Humans, Lung Neoplasms, Middle Aged, Neoplasm Staging, Prognosis, Risk Factors, Treatment Outcome
DOI: 10.1016/j.lungcan.2012.03.010
ISSN: 0169-5002
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2012 Elsevier Ireland Ltd
Deposited On: 12 Dec 2013 02:31
Last Modified: 16 Mar 2014 23:43

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