Abstract 663P
Background
Chemotherapies combined with immune-checkpoint inhibitors (Chemo-ICIs) are the standard of care in first-line therapy for ED-SCLC. Although there is no comparative data on ATZ vs. DUR, their efficacies appear to be equivalent based on results from IMpower133 and CASPIAN trials. DUR can be administered with either CDDP or CBDCA, whereas ATZ only with CBDCA. Although CDDP is conventionally considered more effective in CDDP-fit patients (pts), little is known in combined with ICIs.
Methods
This is an exploratory analysis on multicenter retrospective study of RWD. Clinical outcomes of ED-SCLC pts who had received Chemo-ICIs were collected from electronic medical records of each hospital. After excluding poor PS and Ccr <60 ml/min pts, PSM was performed to adjust difference of pts' backgrounds of two groups (DUR-G vs. ATZ-G).
Results
From August 2018 to December 2022, 274 pts (DUR/ATZ: 98/176) were extracted from 8 hospitals in Japan. Among 128 pts with both PS 0-1 and Ccr ³60, 31 pts received CDDP+ETP+DUR, and 98 CBDCA+ETP+ATZ. After PSM, total 50 pts: 25 pts in each group were evaluated. Response rate was 88.0% for DUR-G and 76.0% for ATZ-G (p=0.463). Median overall survivals of DUR-G vs. ATZ-G were 21.4 (95% confidence interval [CI]: 14.0-not reached [NR]) vs. 19.8 (95% CI: 12.2-NR) months, respectively (p=0.490). Median progression-free survivals of DUR-G vs. ATZ-G were 5.6 (95% CI: 5.1-7.5) vs. 4.7 (95% CI: 4.3-6.5) months, respectively (p=0.500). Median time to treatment failures of DUR-G vs. ATZ-G were 4.9 (95% CI: 4.1-11.0) vs. 4.7 (95% CI: 4.2-6.5) months, respectively (p=0.907). No significant safety differences: immune-related adverse events (AEs) ³grade 2; (20% vs. 12%); any grade interstitial lung disease (8% vs. 4%); febrile neutropenia (8% vs. 8%); serious AEs (8% vs. 16%); and number of hospitalizations (median/mean: 2/2.3 vs. 1/1.7) were observed.
Conclusions
Our RWD found a similar effectiveness of CDDP+ETP+DUR vs. CBDCA+ETP+ATZ in CDDP-fit ED-SCLC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
K. Hamai: Financial Interests, Personal, Invited Speaker: AstraZeneca. A. Hata: Financial Interests, Personal, Invited Speaker: Eli Lilly, Chugai Pharamceutical, Pfizer, AstraZeneca, Taiho, MSD, Boehringer Ingelheim. N. Katakami: Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb, MSD, Chugai Pharmaceutical, AstraZeneca, Boehringer Ingelheim, Taiho, Kyowa Kirin, Kyorin, Takeda, Ono Pharmaceutical. All other authors have declared no conflicts of interest.