1488P - Exploring efficacy and safety of immune checkpoint inhibitors (ICI) in extensive stage (ES)- small-cell lung cancer (SCLC) in specific populations: Real-world data from the Durvalumab Expanded Access program Regional European cohort (DEAR)

Background

Platinum-based chemotherapy (CT) with PDL-1 blockade is the standard of care in ES-SCLC. Relevant randomized controlled trials were restricted to patients(pts) with ECOG PS 0-1 at initiation of therapy. These trials also prohibited use of consolidation radiotherapy (RT) or salvage RT to treat of oligo-progression. We aimed to evaluate outcomes in pts with poor ECOG PS and those receiving non-palliative RT, as well as the prevalence and outcomes of durvalumab (DRV) beyond progression.

Methods

A retrospective data collection including pts from 11 centers in four countries. Primary endpoints were overall survival (OS) and duration of treatment (DOT) in the overall population and in the subgroup of pts with ECOG ≥2. Secondary endpoints included safety, OS and DOT in pts treated with non-palliative RT as well as the use of ICI beyond progression.

Results

A total of 100 pts received durvalumab with CT for ES-SCLC. 68% were male, median age was 65 years (range 39-83) and 23% had an ECOG ≥2. Overall, 29% of patients received RT during durvalumab treatment, 22% as salvage/consolidation. Fifteen pts (15%) were treated with DRV beyond progression for a median of 4 cycles (range 1-14). Median OS in the entire cohort was 11.5mo, 13.3mo in pts with ECOG 0-1 and 10.3mo in pts with ECOG ≥2 (p=0.028). Median DOT in the entire cohort was 4.5mo and 4.2 in pts with ECOG ≥2 (p=0.006). Pts receiving non-palliative RT showed a trend toward improved OS and DOT (Table). Eight pts (8%) discontinued DRV due to immune-related adverse events. Table: 1488P

mDOT and mOS in pts receiving non-palliative RT

Conclusions

Treatment with CT and DRV is safe and effective in pts with ES-SCLC with ECOG PS ≥2 as well as in pts receiving concomitant radiotherapy. Treatment discontinuation rate due to toxicity was comparable to that reported in the CASPIAN study.

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.