2002P - A multicentre study assessing the real-world effectiveness of first-line chemotherapy plus immunotherapy in extensive-stage small cell lung cancer (ES-SCLC) patients

Background

First-line chemotherapy plus immunotherapy (CT-IO) has recently demonstrated survival benefit over CT in Extensive-Stage Small Cell Lung Cancer (ES-SCLC) patients, based on randomized phase 3. This retrospective multicentre study assessed the real-world effectiveness of CT-IO since its approval in France in May 2020, in unselected patients.

Methods

Data from all ES-SCLC patients treated with CT-IO at four French hospitals between May 2020 and December 2021 were retrospectively analyzed. Kaplan Meier method was used to estimate OS and real-world progression-free survival (rwPFS), and Cox regression analysis to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) in univariate and multivariate models.

Results

Of 75 patients included, median age was 69 years [IQR: 60.5-72.5], performans status (PS) was 0-1 in 78.7% of patients. Brain and liver metastases were present at baseline in 26.8% and 54.7% of patients respectively, and 28% of patients had corticosteroids ≥ 10 mg/day. At a median follow up of 16.8 months (95%CI: 14.9-23.4), the median OS was 11.4 months (95%CI: 7.7-14.7) with a 12-months OS rate of 43.6% (95%CI: 33.3-57.2). The median rwPFS was 5.3 months (95%CI: 4.8-5.8), 6-months PFS rate was 33.3% (95%CI: 24.2-45.9) and the objective response rate (ORR) was 76.7%. Introduction of delayed IO at the second cycle was not associated with a worse OS (HR 1.62, 95%CI: 0.88-2.97, p=0.132). In multivariate analyses, baseline brain and liver metastases were associated with a shorter OS (HR 3.80 [95%CI: 1.90-7.60] and 3.12 [95%CI: 1.60-6.08] respectively, p<0.001 for both).

Conclusions

Our study showed that survival data in real-world ES-SCLC patients treated with frontline CT-IO were promising and comparable to those obtained from randomized trials, even amongst an unselected population including older patients, with untreated brain metastases or corticosteroids.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.