524P - Treatment pattern and overall survival by lines of therapy among patients with advanced small cell lung cancer in Taiwan

Background

Small cell lung cancer (SCLC) has limited treatment options, especially as the number of treatment lines increases. This study investigated the standard of care (SOC) for advanced SCLC in Taiwan.

Methods

This retrospective cohort study used linked data from Taiwan Cancer Registry (TCR), National Health Insurance Research Database, and Death Registry (2014–2019). Cancer-related information was collected from TCR: age, sex, year of initial diagnosis, initial treatment status, smoking status, and genetic mutations. The algorithm for building lines of pharmacological therapies for SCLC was based on NCCN guidelines, published studies and expert opinions. Median overall survival (OS), with 95% confidence interval (CI) was estimated using the Kaplan-Meier method, referencing from the initiation of each therapy line until death or the end of 2019. Patients with documented extensive stage (ES) were analyzed in the same manner as patients with stage IV SCLC.

Results

We identified 3134 stage IV SCLC patients with a median age 69.9 years at diagnosis. Of these patients, 12% were female, and 83% were smokers. Among 2237 patients who initiated first-line (1L) therapy, 1048 (47%) patients received 2+ lines of therapy, and 349 (16%) received 3+ lines. The predominant treatments were cisplatin plus etoposide in 1L (61%) and topotecan in 2L (58%) whereas 3L treatment options included platinum plus etoposide (38%), topotecan (22%), and etoposide only (17%) regimens. Median OS with 95% CI were 8.4 (8.1–8.7) months after 1L therapy; 4.9 (4.5–5.4) months after 2L therapy, and 4.4 (3.9–5.5) months after 3L therapy. Similar characteristics and treatment regimens were observed among the 1866 patients with documented extensive-stage SCLC, with median OS of 8.6 (8.3–9.1) months after 1L therapy, 5.0 (4.5–5.6) months after 2L therapy, and 5.4 (4.3–6.2) months after 3L therapy.

Conclusions

In Taiwan, treatment regimens for advanced SCLC follow NCCN guidelines; real-world overall survival rates are consistent with published data. These results show that an urgent unmet need exists for SCLC patients. Further study is needed on immunotherapy’s effect on SCLC SOC, as our study predates insurance coverage.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Amgen.

Disclosure

Y. Yang, W-J. Chen, C-H. Chang: Financial Interest, Personal, Full or part-time Employment: Amgen. All other authors have declared no conflict of interest.