Title | Predicting risk of chemotherapy-induced severe neutropenia: A pooled analysis in individual patients data with advanced lung cancer. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Cao, Xiaowen, Apar Kishor Ganti, Thomas Stinchcombe, Melisa L. Wong, James C. Ho, Chen Shen, Yingzhou Liu, Jeffery Crawford, Herbert Pang, and Xiaofei Wang |
Journal | Lung Cancer |
Volume | 141 |
Pagination | 14-20 |
Date Published | 2020 Mar |
ISSN | 1872-8332 |
Keywords | Aged, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Female, Follow-Up Studies, Humans, Incidence, Lung Neoplasms, Male, Models, Statistical, Neutropenia, Prognosis, Randomized Controlled Trials as Topic, ROC Curve, Small Cell Lung Carcinoma, United States |
Abstract | OBJECTIVES: Neutropenia is associated with the risk of life-threatening infections, chemotherapy dose reductions and delays that may compromise outcomes. This analysis was conducted to develop a prediction model for chemotherapy-induced severe neutropenia in lung cancer.MATERIALS AND METHODS: Individual patient data from existing cooperative group phase II/III trials of stages III/IV non-small cell lung cancer or extensive small-cell lung cancer were included. The data were split into training and testing sets. In order to enhance the prediction accuracy and the reliability of the prediction model, lasso method was used for both variable selection and regularization on the training set. The selected variables was fit to a logistic model to obtain regression coefficients. The performance of the final prediction model was evaluated by the area under the ROC curve in both training and testing sets.RESULTS: The dataset was randomly separated into training [7606 (67 %) patients] and testing [3746 (33 %) patients] sets. The final model included: age (>65 years), gender (male), weight (kg), BMI, insurance status (yes/unknown), stage (IIIB/IV/ESSCLC), number of metastatic sites (1, 2 or ≥3), individual drugs (gemcitabine, taxanes), number of chemotherapy agents (2 or ≥3), planned use of growth factors, associated radiation therapy, previous therapy (chemotherapy, radiation, surgery), duration of planned treatment, pleural effusion (yes/unknown), performance status (1, ≥2) and presence of symptoms (yes/unknown).CONCLUSIONS: We have developed a relatively simple model with routinely available pre-treatment variables, to predict for neutropenia. This model should be independently validated prospectively. |
DOI | 10.1016/j.lungcan.2020.01.004 |
Alternate Journal | Lung Cancer |
Original Publication | Predicting risk of chemotherapy-induced severe neutropenia: A pooled analysis in individual patients data with advanced lung cancer. |
PubMed ID | 31926983 |
PubMed Central ID | PMC7063587 |
Grant List | KL2 TR001870 / TR / NCATS NIH HHS / United States P01 CA142538 / CA / NCI NIH HHS / United States R21 AG042894 / AG / NIA NIH HHS / United States |