Comparison of oral versus intravenous etoposide in the management of small‐cell lung cancer; A real‐world, population‐based study
Bibliographic record
Abstract
BACKGROUND: We looked at the utility of PO versus IV etoposide for first-line treatment in combination with a platinum agent (cisplatin/carboplatin) for Small-Cell Lung Cancer (SCLC). METHODS: Patients with SCLC in Alberta from 2008 to 2015 were identified through the registry. Patients were separated on the basis of stage; limited disease (LD) and extensive disease (ED). Chemotherapy naïve patients receiving one cycle of combination chemotherapy, route of etoposide administration, dose reductions and vital status was noted. Survival was assessed using log-rank method and Kaplan-Meyer model RESULTS: About 2066 patients were identified with SCLC. N = 762 were diagnosed with LD and n = 1264 with ED. Patient characteristics were well balanced between age and sex among the two treatment groups. LS-SCLC: No statistically significant difference in overall survival (OS) between IV versus PO Etoposide (17.5 months vs 17.9 months). More dose reductions were seen in the PO group as compared to the IV group (32.5% vs 21.9% P = 0.095). ES-SCLC: There was a nonsignificant numerical difference in OS in IV versus PO Etoposide (8.7 months vs 9.7 months P = 0.124). More dose reductions were noted in the PO group as compared to the IV group (35.3% vs 21.1%). CONCLUSION: The two dosing schemes (PO and IV) yield similar OS in ES and LS SCLC, however, patients in the PO arm did require more dose modifications. Suggesting that PO etoposide may be equivalent and lead to similar outcomes as IV, however, more toxic but saving the patients multiple visits to the chemotherapy suite. Further analyses on cost efficacy and quality of life are required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".