Abstract 1535P
Background
Previous studies have shown that adding immune checkpoint inhibitor (ICI) to chemotherapy for extensive-stage small cell lung cancer (ES-SCLC) is effective and is currently the first-line treatment. However, there is no evidence whether it is effective as a second-line treatment after first-line chemotherapy and ICI combination therapy. Amrubicin is recommended as a second-line treatment for ES-SCLC in the guideline, and it is frequently used in Japan. Here, we report a retrospective study on the efficacy and safety of amrubicin as a second-line treatment for ES-SCLC after ICI therapy.
Methods
This study enrolled patients with ES-SCLC treated with amrubicin as a second-line from April 2012 through December 2021. Patients were divided into two groups: patients previously treated with ICI (pre-ICI group) and those without previous ICI treatment (no-ICI group). The efficacy and the incidence of adverse events were compared between the two groups.
Results
Hundred and fifty patients were enrolled from 6 centers in Japan, and 123 of them were eligible for analysis. There were 27 patients in the pre-ICI group and 96 in the no-ICI group. The characteristics of the patients from the pre-IC/no-ICI groups were as follows: median age 72/69 years old, ECOG PS 0-2 100%/97.9%. The objective response rate was 29.6% in the pre-ICI group and 22,2% in the no-ICI group. The median-time-to-treatment failure was 3.74 months and 2.77 months (HR, 1.14; 95%[CI] 0.90-1.44), the PFS was 3.20 months and 3.21 months (HR, 0,97; 95% [CI], 0.76-1.23) and the median OS was 8.2 months and 8.0 months (HR, 1.09; 95% [CI] 0.83-1.44) in the pre-ICI group and no-ICI group, respectively. One patient (4.3%) from the pre-ICI group and 11 patients (11.5%) from the no-IC group discontinued amrubicin due to adverse events. The incidence of a serious adverse event, including febrile neutropenia, was 22.2% and 24.0%, and the incidence of Grade 3 or higher pneumonitis was 3.7% and 4.2% in the pre-ICI group and no-ICI group, respectively.
Conclusions
This study shows that the efficacy of amrubicin in ES-SCLC remains unchanged irrespective of previous treatment with ICI. Furthermore, serious adverse events were not increased by the use of ICI.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
T. Nishimura.
Funding
Has not received any funding.
Disclosure
K. Ito: Financial Interests, Personal, Invited Speaker: Eli Lilly, Boehringer Ingelheim, Takeda Pharmaceutical, Chugai Pharmaceutical, AstraZeneca, Merck Sharp & Dohme (MSD), Ono Pharmaceutical, Taiho Pharmaceutical. E.C. Gabazza: Financial Interests, Institutional, Funding: TakedaFoundation. T. Kobayashi: Financial Interests, Institutional, Funding: Chugai Pharmaceutical; Financial Interests, Personal, Invited Speaker: AstraZeneca. All other authors have declared no conflicts of interest.