2008P - Brazilian real-world data of immunotherapy (IO) in extensive disease small cell lung cancer (ES-SCLC)

Background

The landmarks of thoracic Oncology in the last two decades have been accompanied by exponential growths in costs, which makes imperative the assessment of the real benefit of new technologies incorporations, particularly those with marginal gains. The combination of IO with platinum-etoposide chemotherapy has become the standard of care in first-line treatment of ES-SCLC, although the absolute difference in overall survival (OS) has reached three months. This study aimed to investigate the impact of this intervention in a real-world cohort of a middle-income country.

Methods

We retrospectively analyzed data from all ES-SCLC patients (pts) from Oncoclinicas, the largest community oncology practice in Latin America, diagnosed and treated between January 2018 and June 2022. Primary objective was median OS according to IO exposure in the first-line setting. Secondary objective was median time to treatment discontinuation (TTD). Relevant clinical characteristics which might impact the results were also evaluated. The project was approved by local Ethics Committee.

Results

In total, 98 patients SCLC pts were included in this analysis. The median age was 68 years, 54% were male, 88% were smoking history, and only 12% has ECOG 2-3. At diagnosis, 81% presented with ES-SCLC and 21% has central nervous system metastasis. First-line regimens were atezolizumab + platinum-etoposide in 47%, platinum-etoposide in 44% and platinum-irinotecan in 9%. Median follow-up was 5 months. Among ES-SCLC pts who received IO in their first-line treatment, median mOS was 14.03 months compared to 7.43 months in those who did not receive IO (HR: 0.76, CI 0.42 – 1.40, p = 0.39). Median TTD of the first-line IO was 7.03 months compared to 3.80 months of those who received chemotherapy only (HR: 0.43, CI 0.24 – 0.76, p = 0.003).

Conclusions

There are few real-world cohorts evaluating the impact of IO in ES-SCLC, limited to high-income countries. Our data suggest that IO may have a meaningful impact in the outcome of ES-SCLC, with median OS comparable to clinical trials. Larger sample small sample size and longer follow-up are needed for conclusive statements, but we will continuously monitor the value of IO as they are introduced in clinical practice for ES-SCLC.

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.