Abstract 1799P
Background
Platinum based chemotherapy is the standard of care in first line treatment for patients with Extensive-Stage Small-Cell-Lung-Cancer (ES-SCLC). Addition of immunotherapy in combination with chemotherapy (CT) in this setting is controversial.
Methods
We performed a meta-analysis of randomized trials comparing immune checkpoint inhibitor plus CT with CT alone in first line treatment for ES-SCLC. The outcomes included overall survival (OS), progression-free survival (PFS) and objective response rate (ORR).
Results
Five eligible phase III studies (IMPOWER 133, CASPIAN, KEYNOTE 604, CHECKMATE 451 and Reck et al 2016) and a randomized phase II (ECOG-ACRIN 5161) included 3609 patients (2382 males, mostly smokers (95%), median age 64 years). Immunotherapy + CT was significantly associated (hazard ratio [95% confidence interval]) with prolonged OS (0.84 [0.78-0.90]; p < 0.00001) and PFS (0.78 [0.73-0.83]; p < 0.00001). OS benefit was observed with anti-PD-L1 (HR=0.72; p<0.0001), anti-PD-1 (HR=0.80; p<0.001) and anti-CTLA-4 (HR=0.90; p=0.04). There was no statistically difference for ORR (odds ratio 1.14 [0.98-1.33]; p =0.10). Serious grade 3-4 adverse events were more frequent with immunotherapy (odds ratio 1.73 [1.06-2.82]; p =0.03). Latest update of studies results will be presented.
Conclusions
First-line immunotherapy + CT combination appears superior to CT alone for ES-SCLC for OS and PFS and can be consider the new standard of treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Chouaid: Honoraria (self): MSD; Honoraria (self): AstraZeneca; Honoraria (self): Roche; Honoraria (self): Bristol Myers Suibb; Honoraria (self): Novartis; Honoraria (self): Pierre Fabre Oncology. All other authors have declared no conflicts of interest.