Abstract 707P
Background
In recent years, combination therapy with immune checkpoint inhibitors and chemotherapy has become the first-line treatment for extensive-stage small cell lung cancer. However, prognostic factors for extensive-stage small cell lung cancer are still unclear. In this study, we investigated prognostic factors for small cell lung cancer using real-world data.
Methods
We conducted a retrospective, multicenter study and enrolled 90 patients with extensive-stage small cell lung cancer who received combination therapy with immune checkpoint inhibitors and chemotherapy as first-line treatment from September 2019 to December 2022 in six hospitals in Japan. To investigate prognostic factors, univariate and multivariate analyses for overall survival were performed.
Results
In all patient groups, the progression free survival was 4.9 months (95% confidence interval [CI]: 4.3–5.4 months), and the median overall survival was 9.7 months (95% CI: 8.7–16.5 months). In univariate analysis of overall survival, ECOG PS2 or higher (Hazard ratio [HR] = 2.71, 95%CI: 1.38–5.32, p=0.0037), onset of immune related adverse events (HR = 0.40, 95%CI: 0.19-0.83, p=0.013) were prognostic factors. The choice of treatment with durvalumab or atezolizumab was not a prognostic factor (HR = 1.22, 95%CI: 0.66-2.22, p=0.51). These results were similar in multivariate analysis (Table). In particular, median survival time was 22 months in patients with immune related adverse events (n=23) and 9.3 months in patients without immune related adverse events (n=67), indicating that immune related adverse events were a prognostic factor. Table: 707P
| Factor | Hazard ratio (95% CI) | p value |
| Age <70 or ≥70 | 1.49 (0.81-2.73) | 0.2 |
| CE+Atezolizumab or CE+Durvalumab | 1.21 (0.66-2.23) | 0.54 |
| ECOG PS 0-1 or ≥2 | 3.94 (1.92-8.08) | 0.00019 |
| irAE without or with | 0.30 (0.14-0.65) | 0.0021 |
Conclusions
The results of this study show that immune-related adverse events are associated with improved survival outcomes in patients with extensive-stage small cell lung cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
K. Ito: Financial Interests, Personal, Invited Speaker: Eli Lilly, Boehringer Ingelheim, Takeda Pharmaceutical, Chugai Pharmaceutical, AstraZeneca, Pfizer, Merck Sharp & Dohme, Ono Pharmaceutical, Taiho Pharmaceutical. E.C. Gabazza: Financial Interests, Personal, Funding: Takeda Foundations. T. Kobayashi: Financial Interests, Institutional, Research Grant: Chugai Pharma; Financial Interests, Personal, Invited Speaker: AstraZeneca. All other authors have declared no conflicts of interest.