Platinum Combination Chemotherapy Is Poorly Tolerated in Malnourished Advanced Lung Cancer Patients with Poor Performance Status

Abstract

This study aimed to explore the tolerability and safety of platinum combination chemotherapy in malnourished patients with advanced non-small cell lung cancer (NSCLC) and poor performance status (PS). We retrospectively reviewed NSCLC patients with a PS of 2 who received first-line platinum combination chemotherapy at the Shizuoka Cancer Center between December 2009 and December 2014. Nutritional status was classified using the Glasgow Prognostic Score (GPS), which is an indicator of systemic inflammation and malnutrition. The malnourished group included patients with a GPS of 2, and the well-nourished group included patients with a GPS of 0–1. Among the 31 consecutive eligible patients, the malnourished group completed fewer chemotherapy cycles than the well-nourished group (median: 2 cycles vs. 4 cycles, p = 0.0091). Hematological and non-hematological toxicities were similar in both groups. The malnourished group also experienced poorer outcomes than the well-nourished group (response rate: 0% vs. 25%; median progression-free survival: 1.7 months vs. 4.9 months, p = 0.018; and median overall survival: 5.7 months vs. 8.3 months, p = 0.028). Malnutrition might decrease the tolerability and efficacy of platinum combination chemotherapy for patients with advanced NSCLC and poor PS.