Symptom Burden of Chemotherapy-Induced Myelosuppression in Extensive-Stage Small Cell Lung Cancer

In a retrospective study, researchers assessed the burden from symptoms of neutropenia, anemia, and thrombocytopenia related to chemotherapy-induced myelosuppression (CIM) among patients with extensive-stage small cell lung cancer (ES-SCLC). The lead author, L. Hart, who presented the study in poster form at AMCP 2022, reported the collaborators’ conclusion that “there is a high burden related to CIM among chemotherapy-treated patients with ES-SCLC in the community oncology setting.”

The study identified a total of 1,239 retrospective patients from Florida Cancer Specialist and Research Institute records who had ES-SCLC and subsequently received chemotherapy. Initiation of chemotherapy was chosen as the index date, and patients were followed from that date until the earliest of death, loss to follow-up, or study end date. The incidence of CIM episodes, treatment patterns, and use of supportive care during chemotherapy were assessed. Additional outcomes of interest included eligibility to receive blood transfusions and overall survival (OS) after indexing.

According to the article, 94% of the patients initialized first-line chemotherapy at the index date. Over a mean follow-up of 10 months, the investigators observed that 52.8% of patients received one or more further lines of therapy. Regarding the symptom burdens of interest, 32.7% of patients had grade III anemia reported, with a frequency of 1.9 episodes. Furthermore, 26.5% and 26.9% of patients had grade III and grade IV neutropenia, with a mean frequency of 1.4 episodes for both grades. Grade III and grade IV thrombocytopenia was observed in 31% and 16.1% of patients, with a mean frequency of 1.8 episodes. Additionally, 32.6% of patients were eligible to receive a blood transfusion, among which 89.7% received granulocyte colony-stimulating factor (G-CSF), 24.4% received erythropoiesis-stimulating agents (ESA), and 51.2% received intravenous (IV) hydration. Finally, the median OS was 9.2 months.

Overall, Hart and colleagues deemed that chemotherapy-induced myelosuppression-related symptoms were a significant burden for patients with ES-SCLC. In closing, the study’s authors suggested that “therapies to protect bone marrow from myelosuppression could make treatment safter, reduce the need for supportive care, and potentially prevent treatment of complications at expensive sites of care.”