Abstract 1660P
Background
Small cell lung cancer (SCLC) accounts for approximately 13% of lung cancers. Changes in the standard systemic treatment of patients with SCLC have not occurred until very recently with the introduction of immunotherapy to the standard first-line treatment. We aimed to evaluate changes in the clinical management of patients with SCLC during the last decade compared to the previous one in a real-world setting.
Methods
Retrospective data were collected from patients with SCLC at our institution, from 2000 to 2021 and divided into two cohorts: cohort 1 (C1) from 2000-2010, and cohort 2 (C2) from 2011-2021. We evaluated disease stage, assessment for brain metastases at diagnosis, presence of brain and liver metastases, use of prophylactic cranial irradiation (PCI), and platinum agent as first-line chemotherapy (cisplatin vs. carboplatin). Survival outcomes were determined.
Results
This study included 303 patients. No statistically significant differences were found regarding disease staging with 64.7% and 70.6% of patients diagnosed with stage IV, in C1 and C2, respectively (p=0.675). The presence of liver metastases at diagnosis was higher in C2 (31.8%), vs. C1 (20.6%) (p=0.043). Brain imaging at diagnosis increased from 62.8% (C1) to 89.5% (C2) (p=<0.001). Regarding treatment, the use of PCI was similar in both cohorts: 33.3% in C1, and 30.8% in C2 (p=0.686). Furthermore, treatment with cisplatin was higher in C1 (40.2%) vs. C2 (19.9%), whereas carboplatin was more frequently used in C2 (44.1% in C1 vs. 67.7% in C2). Finally, no significant differences in median overall survival (mOS) were found neither for stage III (13.96 months for C1 vs, (C2) 15.29 months for C2), nor for stage IV patients, who had a mOS of 5.24 months (m), vs 7.01m in C1 and C2, respectively (p=0.832).
Conclusions
An increase in the use of carboplatin, as well as more frequent brain imaging at diagnosis have been incorporated in the more recent management of patients with SCLC. However, this has not translated into a significant impact on survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Arriola: Other, Institutional, Invited Speaker: BMS; Other, Institutional, Invited Speaker: AstraZeneca; Other, Institutional, Invited Speaker: Roche; Other, Institutional, Invited Speaker: MSD; Other, Institutional, Invited Speaker: Pfizer; Other, Institutional, Invited Speaker: Lilly; Other, Institutional, Invited Speaker: Boehringer Ingelheim. All other authors have declared no conflicts of interest.