Abstract 524P
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.
Resources from the same session
571P - Dacomitinib in treatment-naïve EGFR-mutant NSCLC patients with multiple brain metastases: Initial efficacy and safety data from a phase II study
Presenter: Yongfeng Yu
Session: Poster Display
Resources:
Abstract
572P - Multivariable five-year survival prediction model for prognosing patients with EGFR-mutated NSCLC treated with EGFR-TKIs
Presenter: Qi-An Wang
Session: Poster Display
Resources:
Abstract
573P - LUMINATE-103: Real-world treatment patterns and outcomes of patients (pts) with epidermal growth factor receptor mutant (EGFR MU), non-squamous (NSQ) locally advanced/metastatic non-small cell lung cancer (a/mNSCLC): Pooled analysis of large US electronic health record (EHR) datasets
Presenter: Byoung Chul Cho
Session: Poster Display
Resources:
Abstract
574P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC harboring uncommon EGFR mutations
Presenter: Lin Wu
Session: Poster Display
Resources:
Abstract
575P - Efficacy and safety of dacomitinib in treatment-naïve patients with advanced NSCLC and brain metastasis: A multicenter cohort study
Presenter: Puyuan Xing
Session: Poster Display
Resources:
Abstract
576P - Clonality of both EGFR and co-occurring TP53 mutations affect the treatment efficacy of the third-generation EGFR-TKIs in advanced-stage EGFR-mutant non-small cell lung cancer
Presenter: Wen Feng Fang
Session: Poster Display
Resources:
Abstract
577P - A study of the efficacy and safety of amivantamab in EGFR exon 20 insertion (E20I) mutations in NSCLC
Presenter: Daeho Choi
Session: Poster Display
Resources:
Abstract
578P - Tyrosine kinase inhibitor treatment of elderly patients with epidermal growth factor receptor mutated advanced non-small cell lung cancer: A multi-institute retrospective study
Presenter: Ling-Jen Hung
Session: Poster Display
Resources:
Abstract
579P - Real-world study of dacomitinib as first-line treatment for patients with EGFR-mutant non-small cell lung cancer
Presenter: Ji Eun Shin
Session: Poster Display
Resources:
Abstract
580P - Efficacy and safety of dacomitinib as first-line treatment for advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor <italic>(EGFR)</italic> 21L858R mutation: A multicenter, ambispective, consecutive case-series study
Presenter: Shouzheng Wang
Session: Poster Display
Resources:
Abstract