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
484P - Treatment (tx) patterns and outcomes in resectable early-stage EGFR-mutated (EGFRm) NSCLC in South Korea: Subgroup analysis of a global real-world (rw) study
Presenter: Myung-Ju Ahn
Session: Poster Display
Resources:
Abstract
485P - LDCT lung cancer screening of never-smokers meta-analysis subgroup analysis: Adenocarcinoma is the highly predictive histology identified in never-smokers
Presenter: Sai-Hong Ou
Session: Poster Display
Resources:
Abstract
486P - Fiscal feasibility and implications of integrating lung cancer screening into Hong Kong’s healthcare system
Presenter: Herbert Ho Fung Loong
Session: Poster Display
Resources:
Abstract
487P - Evaluating the performance of the USPSTF lung cancer screening guidelines in an Asian population of lung cancer patients
Presenter: Jian Wei Tan
Session: Poster Display
Resources:
Abstract
488P - Pulmonary ground glass opacity lesions: Immune ecosystem and its clinical relevances of early-stage lung adenocarcinoma
Presenter: Shensi Shen
Session: Poster Display
Resources:
Abstract
489TiP - BGB-LC-202 (NCT05577702): Phase II Umbrella study of tislelizumab (TIS) monotherapy and TIS-based immunotherapy combinations +/- chemotherapy (CT) as neoadjuvant treatment in Chinese patients (pts) with resectable stage II to IIIA non-small cell lung cancer (NSCLC)
Presenter: Wentao Yu
Session: Poster Display
Resources:
Abstract
491P - Furmonertinib as adjuvant therapy for elderly patients in resected EGFR-mutated non-small cell lung cancer: A double-center, real-world experience
Presenter: Ziheng Wu
Session: Poster Display
Resources:
Abstract
492P - Penpulimab-based combination neoadjuvant/adjuvant therapy for patients with resectable locally advanced non-small cell lung cancer: Preliminary results from a phase II study (ALTER-L043)
Presenter: Changli Wang
Session: Poster Display
Resources:
Abstract
493P - The prognostic value of 4L lymph node dissection in left-sided operable non-small cell lung cancer: A systematic review and meta-analysis
Presenter: Lei Peng
Session: Poster Display
Resources:
Abstract
495P - Intrinsic STING of CD8+T cells regulates self-metabolic reprogramming and exerts anti-tumor effects
Presenter: Qiuli Xu
Session: Poster Display
Resources:
Abstract