Abstract 520P
Background
Adding atezolizumab to the established etoposide and carboplatin chemotherapy (AECb) for extensive-stage small cell lung cancer (ES-SCLC) is now standard, following success of Impower 133 trial. Controlling central nervous system (CNS) progression is pivotal for patients’ survival and quality of life. We explored a role of atezolizumab in controlling brain metastasis in ES-SCLC patients.
Methods
A total of 156 patients, diagnosed with ES-SCLC and received 1st line chemotherapy between August 2016 and July 2022 at Korea University Guro Hospital, were included. Survival data, comprising progression-free survival (PFS), overall survival (OS), time to intracranial progression (TTicP, with deaths censored) and brain PFS, were evaluated.
Results
During the study period, 79 (50.6%) patients underwent chemotherapy without atezolizumab, while 77 (49.4%) patients received AECb as their initial treatment. The median follow-up duration was 23.8 months, and there were no discernible differences between two groups in terms of age, sex and primary metastatic sites. Patients in the AECb group exhibited improved CNS outcomes: 27 (34.2%) and 16 (20.8%) patients experienced intracranial progression, with 24 (30.4%) and 14 (18.2%) cases of new brain metastasis. Both TTicP (median: 14.6 months vs. not reached; 12-month TTicP rate: 65.4% vs. 84.4%, P = 0.003) and brain PFS (median: 8.2 vs. 11.7 months; 12-month brain PFS rate 30.2% vs. 48.6%, P = 0.001) were significantly prolonged in the AECb group. These findings remained consistent even after adjusting for age, initial metastatic site, and prophylactic cranial irradiation (PCI). As expected, the AECb group demonstrated favorable survival outcomes, marked by improved PFS (median: 4.4 vs. 4.6 months, P = 0.004) and OS (median: 10.2 vs. 12.6 months, P = 0.001).
Conclusions
The addition of atezolizumab to conventional chemotherapy not only enhances patients’ survival but also improves intracranial disease control, thereby extending the duration of time to intra-cranial progression. This is first real-world data supporting benefits of atezolizumab in controlling intracranial progression in SCLC patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
352TiP - Randomized phase III study of daratumumab (D) versus bortezomib plus D as a maintenance therapy after D-MPB for elderly or non-elderly patients refusing transplant with untreated multiple myeloma (JCOG1911, B-DASH study)
Presenter: Tomotaka Suzuki
Session: Poster Display
Resources:
Abstract
362P - Efficacy and safety of MCLA-129, an anti-EGFR/c-MET bispecific antibody, in head and neck squamous cell cancer (HNSCC)
Presenter: Irene Braña
Session: Poster Display
Resources:
Abstract
363P - Effect of financial distress and mental well-being of patients with early vs advanced oral cancer on informal caregiver's quality of life: A prospective real-world data from public health sector hospital
Presenter: Abhinav Thaduri
Session: Poster Display
Resources:
Abstract
364P - Artificial intelligence provides more accurately neck lymph nodes auto-segmentation in radiotherapy
Presenter: chiencheh Chen
Session: Poster Display
Resources:
Abstract
365P - Radiotherapy treatment outcomes and treatment compliance of nasopharyngeal cancer patients in Sabah: A retrospective analysis
Presenter: Anbarasan Anbazagan
Session: Poster Display
Resources:
Abstract
366P - Pre-treatment oral fungal microbiome and nasopharyngeal carcinoma prognosis: A population-based cohort study in southern China
Presenter: Yufeng Chen
Session: Poster Display
Resources:
Abstract
367P - Prevalence and association of sarcopenia with mortality in patients with head and neck cancer: A meta-analysis
Presenter: Claire Lim
Session: Poster Display
Resources:
Abstract
368P - Distinct gene expression profiling explored using nanostring tumor signalling 360 panel with validations in different clinical stages of oral submucous fibrosis patients: A first Indian study
Presenter: Yasasve Madhavan
Session: Poster Display
Resources:
Abstract
370P - Low-dose nivolumab with induction chemotherapy for inoperable HNSCC in 111 patients: Response rates, survival, and implications for LMICs
Presenter: Josh Thomas Georgy
Session: Poster Display
Resources:
Abstract
371P - The role of FDG-PET/CT in the assessment of response to radiation therapy in head and neck cancers: A systematic review and meta-analysis
Presenter: Felix Wijovi
Session: Poster Display
Resources:
Abstract