Abstract 1655P
Background
Checkpoint Inhibitors (CPI) have achieved modest clinical activity as salvage therapy in relapsed small cell lung cancer in prospective clinical trials. Data regarding the real-world efficacy and safety of CPI in relapsed / refractory SCLC is widely lacking.
Methods
We present real-world data collected from 10 tertiary care hospitals across Germany of patients with R/R SCLC who were treated with single agent or combination checkpoint-inhibitors focusing on subgroups that were underrepresented in prospective clinical trials, in particular patients with poor performance status and brain metastases.
Results
112 patients who were treated with CPI between 01/2017 and 04/2020 were included (male, 63%; ECOG 0-1, 70%). 52.3% received nivolumab monotherapy, 40.5% nivolumab + ipilimumab (other 7.2%). Median follow up was 21 months (95% CI, 9.3-33.5 months). Patients were heavily pretreated with a median line of 2 prior therapies (range, 1-8). Overall disease control rate (DCR) was 31.5% and differed numerically between single (25.9%) and combination CPI treatment (40.0%)(p=0.12). The median duration of response was 21.5 months (95% CI, 14.8-28.3 months) and was significantly higher for combination CPI (NE) vs single agent CPI (9.1m; 95% CI, 6.7-11.6m)(HR, 0.59; 95% CI, 0.36-0-94). Median real-world PFS and OS for all patients were 2.2 (95% CI, 1.8-2.7 months) and 5.8 months (95% CI, 1.7-9.8 months) and did not differ between single or combination CPI (HR, 1.02; 95% CI, 0.64-1.63). Overall 12- and 18-month survival was 33.9% and 23.2%, respectively. Treatment beyond progression was documented in 30.4%. Adverse events (AE) were documented in 81%, 2 patients were permanently discontinued due to AEs.
Conclusions
A noteworthy proportion of patients with heavily pretreated R/R SCLC derives long-term clinical benefit from checkpoint inhibitor therapy with long duration of responses. DOR was significantly different between single and combination CPI, but did not translate into longer OS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J.A. Stratmann: Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Funding: AstraZeneca; Financial Interests, Personal, Advisory Board: Roche. A. Atmaca: Financial Interests, Personal, Advisory Board: BMS. N. Frost: Financial Interests, Personal, Advisory Board: AbbVie; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: BelGene. J. Alt: Financial Interests, Personal, Advisory Board: BMS. C.F. Waller: Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Chugai; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Role: Mylan; Financial Interests, Personal, Advisory Role: Alvotech; Financial Interests, Personal, Other: Ipsen; Financial Interests, Personal, Other: Lilly. M. Wermke: Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Kite; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Merck; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: Heidelberg Pharma; Financial Interests, Personal, Advisory Board: Glenmark. M. Sebastian: Financial Interests, Personal, Research Grant: AstraZeneca; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: BMS; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: CureVac; Financial Interests, Personal, Advisory Board: BioNTech; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Janssen-Cilag; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Takeda; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Merck. All other authors have declared no conflicts of interest.