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
602P - COLUMBUS 7-year update: A randomized, open-label, phase III trial of encorafenib (Enco) + binimetinib (Bini) vs vemurafenib (Vemu) or Enco in patients (Pts) with BRAF V600-mutant melanoma
Presenter: Andrew Haydon
Session: Poster Display
Resources:
Abstract
603P - An individualised postoperative radiological surveillance schedule for IDH-wildtype glioblastoma patients (HK-GBM Registry)
Presenter: Jason Chak Yan Li
Session: Poster Display
Resources:
Abstract
604P - Cabozantinib versus placebo in patients with radioiodine-refractory differentiated thyroid cancer who progressed after prior VEGFR-targeted therapy: Outcomes from COSMIC-311 by BRAF status
Presenter: Marcia Brose
Session: Poster Display
Resources:
Abstract
606P - BRAF and NRAS mutations are associated with poor prognosis in Asians with acral-lentiginous and nodular cutaneous melanoma
Presenter: Sumadi Lukman Anwar
Session: Poster Display
Resources:
Abstract
607P - Single institutional outcomes of radiotherapy and systemic therapy for melanoma brain metastases in Japan
Presenter: Naoya Yamazaki
Session: Poster Display
Resources:
Abstract
608P - The efficacy of immune checkpoint inhibitors and targeted therapy in mucosal melanomas: A systematic review and meta-analysis
Presenter: Andrea Teo
Session: Poster Display
Resources:
Abstract
609P - The association between thyroid function abnormalities and vitiligo induced by pembrolizumab regarding prognosis in patients with advanced melanoma
Presenter: Moez Mobarek
Session: Poster Display
Resources:
Abstract
610P - Analyzing the clinical benefit of the evidence presented at these congresses and utilizing a standardized scale to quantify it will significantly enhance our understanding of the studies showcased, allowing for more objective evaluation and interpretation
Presenter: Charles Jeffrey Tan
Session: Poster Display
Resources:
Abstract
611P - ESMO-magnitude of clinical benefit scale (MCBS) scores for phase III trials of adjuvant and curative therapies at the 2022 ASCO annual meeting (ASCO22)
Presenter: Thi Thao Vi Luong
Session: Poster Display
Resources:
Abstract
612P - Is the juice worth the squeeze? Overall survival gain per unit treatment time as a metric of clinical benefit of systemic treatment in incurable cancers
Presenter: Vodathi Bamunuarachchi
Session: Poster Display
Resources:
Abstract