Abstract 710P
Background
The combination of an anti-PD-L1 antibody plus etoposide with either cisplatin or carboplatin (platinum-etoposide) has become the standard of care for extensive-stage small-cell lung cancer (ES-SCLC) patients. While the relationship between geriatric assessment and effectiveness has been reported, the correlation with tolerability in elderly ES-SCLC patients remains unclear.
Methods
From August 2019 to April 2024, we retrospectively analyzed patients aged ≥ 65 years treated with an anti-PD-L1 antibody plus platinum-etoposide for ES-SCLC in a single institution. The relationship between low body mass index (BMI), one of the parameters of geriatric assessment, and treatment tolerability was analyzed. Tolerability was defined as whether patients could completely receive 4 courses of the combination of an anti-PD-L1 antibody plus platinum-etoposide. Additionally, efficacy and safety were evaluated.
Results
Seventy-one patients were included. The median age was 73 years (range, 65-91), 51 patients (72%) were male, and 54 (76%) had Eastern Cooperative Oncology Group performance status (PS) 0 or 1. Of the total cohort, 16 patients (23%) had low BMI (< 19 kg/m2) and 55 patients (77%) had non-low BMI. Eight patients (50%) with low BMI demonstrated tolerability, whereas 44 patients (80%) with non-low BMI demonstrated tolerability. There were no significant differences in progression-free survival, overall survival, or the occurrence rate of Grade 3 or higher adverse events between these two groups. In the multivariate analysis, patients with low BMI and PS ≥ 2 had significantly worse tolerability (OR: 0.24 [95% CI: 0.06-0.88], p = 0.03 and OR: 0.13 [95% CI: 0.04-0.48], p < 0.01, respectively).
Conclusions
Low BMI and poor PS were associated with worse tolerability in elderly patients with ES-SCLC receiving an anti-PD-L1 antibody plus platinum-etoposide.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Graduate School of Medicine, Nippon Medical School.
Funding
Has not received any funding.
Disclosure
A. Miyanaga: Financial Interests, Personal, Invited Speaker: AstraZeneca, Nippon Kayaku, Merck, Kyowa Kirin, Pfizer. K. Kasahara: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical, Eli Lilly, Bristol Myers Squibb. M. Seike: Financial Interests, Personal, Sponsor/Funding: Taiho Pharmaceutical, Chugai Pharmaceutical, Eli Lilly, Nippon Boehringer Ingelheim, Nippon Kayaku, Kyowa Hakko Kirin; Financial Interests, Personal, Invited Speaker: AstraZeneca, MSD K.K, Chugai Pharmaceutical, Taiho Pharmaceutical, Eli Lilly, Ono Pharmaceutical, Bristol Myers Squibb, Nippon Boehringer Ingelheim, Pfizer, Novartis, Takeda Pharmaceutical, Kyowa Hakko Kirin, Nippon Kayaku, Daiichi Sankyo Company, Merck Biopharma, Amgen. All other authors have declared no conflicts of interest.