Abstract 1798P
Background
Although SCLC is an aggressive cancer, few useful treatment options exist after relapse. Information concerning the efficacy of CP in patients with SCLC is limited, despite common use in real-life.
Methods
Medical records of all patients (pts) with SCLC treated at our institution from 2010 to 2019 were reviewed. The objectives were to investigate the frequency at which CP regimen was administered to SCLC pts in clinical practice, and to determine the objective response rate (ORR) and median progression-free survival (mPFS) in the CP cohort compared to alternative regimens.
Results
A total of 442 pts with SCLC were analyzed. Among them, 70 pts (15.8%) received CP as salvage treatment (Tx): 25 pts received CP in second line (2L, 35.7%), 28 in third line (3L, 40%), 12 in fourth line (4L, 17.1%) and 5 after fifth line (5L, 7.1%). In 2L, after progression to first-line (1L) platinum-etoposide (PE), CP showed ORR of 40% and mPFS of 3 months (m) (CI95% 2.1 – 4.8). No differences were found in ORR (40% vs 26.2%; p=0.2) and mPFS (3 vs 3.6 m; p=0.09) when compared to non-CP Tx (n= 177, with n=64 receiving other platinum-based combinations and n=9 immunotherapy [IT]). In 3L, CP showed ORR of 30% and a mPFS of 2.8m (CI95% 2.1 – 5.2). Among them, 68% pts received PE and standard 2L with single agent chemotherapy or CAV regimen, and 18% were treated with PE as 1L and 2L. A significant increase in ORR (30% vs 9.4%; p=0.03) was observed in CP compared to non-CP (n= 69, with n=16 receiving PE or CAV and n=10 IT). ORR improvement was independence of 2L best response. However, no association was found in mPFS (2.8m vs 2.3m; p=0.85). In 4L, a significant increase in ORR (60% vs 7.4%; p=0.001) was also observed in CP patients compared to non-PCT pts (n=30 with n=14 receiving PE, CAV or other chemotherapy combinations and n=2 IT). However, no further differences were found in mPFS (3.5m vs 1.7m; p=0.59).
Conclusions
Our data suggest comparable or superior ORR with CP in the SCLC refractory setting, although no differences in mPFS was observed. CP combination as salvage treatment is feasible and may have a place in patients with symptomatic disease where tumor response is needed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
G. Villacampa Javierre: Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy: AstraZeneca. P. Iranzo: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Merck Sharp & Dohme Boehringer Ingelheim MSD Oncology Rovi Kyowa Kirin Grunenthal Pharma S.A.; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Bristol-Myers Squibb Pfizer Merck Sharp & Dohme Boehringer Ingelheim Grunenthal Pharma S.A. A. Callejo: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Pfizer Boehringer Ingelheim MSD Oncology Kyowa Kirin; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Bristol-Myers Squibb Pfizer Boehringer Ingelheim MSD Oncology Celgene. N. Pardo: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Pfizer Boehringer Ingelheim; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Pfizer. S. Cedres: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Pfizer Boehringer Ingelheim MSD Oncology Amphera; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Pfizer Boehringer Ingelheim. A. Martinez-Marti: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Merck Sharp & Dohme Pfizer Boehringer Ingelheim MSD Oncology; Speaker Bureau/Expert testimony: F. Hoffmann La Roche AG Bristol-Myers Squibb Recipient Merck Sharp & Dohme Pfizer Recipient Boehringer Ingelheim; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Bristol-Myers Squibb Pfizer Merck Sharp & Dohme Boehringer Ingelheim. R. Dienstmann: Advisory/Consultancy: Roche, Boehringer Ingelheim; Speaker Bureau/Expert testimony: Roche, Ipsen, Amgen, Servier, Sanofi, Merck Sharp & Dohme; Research grant/Funding (self), Research grant/Funding (institution): Merck and Pierre Fabre. E. Felip: Advisory/Consultancy: AbbVie, AstraZeneca, Blueprint medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Guardant Health, Janssen, Medscape, Merck KGaA, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Takeda, Touchtime.; Research grant/Funding (self), Research grant/Funding (institution): Fundación Merck Salud, Grant for Oncology Innovation EMD Serono. A. Navarro: Advisory/Consultancy: Bristol-Myers Squibb Recipient F. Hoffmann La Roche AG Pfizer Boehringer Ingelheim Oryzon Genomics; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG Bristol-Myers Squibb Pfizer Merck Sharp & Dohme Boehringer Ingelheim. All other authors have declared no conflicts of interest.