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
561P - Mechanisms of osimertinib resistance using circulating tumor DNA analyses for EGFR-mutated non-small cell lung cancer, results from ELUCIDATOR: A prospective observational multicenter study
Presenter: Daijiro Harada
Session: Poster Display
Resources:
Abstract
562P - First-line (1L) osimertinib (osi) ± platinum-pemetrexed in patients (pts) with EGFRm advanced NSCLC: FLAURA2 China cohort
Presenter: Yan Yu
Session: Poster Display
Resources:
Abstract
563P - Real-world effectiveness and safety of first-line osimertinib for EGFR-mutated advanced NSCLC in China (FLOURISH study)
Presenter: Jianya Zhou
Session: Poster Display
Resources:
Abstract
564P - Co-occurring EGFR p.E709X mutation affects the treatment response to the third-generation EGFR-TKIs in EGFR p.G719X-mutant patients with advanced NSCLC
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
565P - Genome-guided targeted therapy combination improves survival in patients with advanced EGFR mutation positive NSCLC failing osimertinib
Presenter: Molly Li
Session: Poster Display
Resources:
Abstract
566P - Safety of tepotinib + osimertinib in EGFR-mutant NSCLC with MET amplification after first-line osimertinib
Presenter: Chong Kin Liam
Session: Poster Display
Resources:
Abstract
567P - Furmonertinib in combination with bevacizumab and intrathecal chemotherapy as later-line re-challenge treatment in EGFR –mutated NSCLC patients with leptomeningeal metastasis after third-generation EGFR-TKIs treatment failure
Presenter: Fang Cun
Session: Poster Display
Resources:
Abstract
568P - First-line (1L) osimertinib + platinum-pemetrexed in EGFR-mutated (EGFRm) advanced NSCLC: Updated FLAURA2 safety run-in (SRI) results
Presenter: David Planchard
Session: Poster Display
Resources:
Abstract
569P - Whole-transcriptome sequencing of transformed small-cell lung cancer from EGFR-mutated lung adenocarcinoma reveals LUAD–like and SCLC–like subsets
Presenter: Chan-Yuan Zhang
Session: Poster Display
Resources:
Abstract
570P - First-line osimertinib for patients with advanced NSCLC harboring EGFR mutations: A real-world study
Presenter: Wenxiang Ji
Session: Poster Display
Resources:
Abstract