1807P - Real world data on 442 patients (p) with small cell lung cancer (SCLC) treated in the last ten years at Vall d’Hebron Hospital

Background

SCLC is a highly aggressive tumour, with diverse treatment (ttm) options and heterogeneous outcomes. Real world data on prognostic markers are scarce in the literature.

Methods

We performed a comprehensive analysis of clinical data of all SCLC p who received ttm in our centre from May 2009 to November 2019. We estimated overall survival (OS) from date of diagnosis with the Kaplan-Meier method. Cox models were used to estimate hazard ratios (HR) and to assess OS prognostic factors.

Results

442p were included, 76% were male, median age was 65 years (y) and 8p (2%) were non-smokers. ECOG was 1 in most cases (57%) 317p (72%) were metastatic (met) at diagnosis, 17p (4%) had surgical ttm. Overall median OS (mOS) was 11.6m (CI95% 10-12.7). A total of 159p (36%) participated in clinical trials (CT), most of them (60%) in 2^nd line (2L). 316p received 1^st L based on platinum in met setting: 247 (78%) with carboplatin (CB) + etoposide (ET) and 69p (21%) with cisplatin (CD) + ET. 2^nd L was offered to 162p (51%), mostly CT in 74p (46%), topotecan (TP) in 29%, CB + paclitaxel (TAX) in 14%, CB + ET in 11%. 3^rd L was offered to 63p (20%), 30% were treated with CB + TAX, 28% participated in CT, 21% were treated with TP and 21% with other regimens. Furthermore, 39p (12%) received 4^th or 5^th L. From 108p (23%) that presented with initial locally-advanced disease and were treated with thoracic radiotherapy, ET + CB was offered to 62p (57%) or CD to 46p (43%). 66p (61%) achieved partial response. 68p (63%) were treated with prophylactic cranial irradiation (PCI). Elderly p were represented in our cohort: 147p (34%) were 70y or older; 73% (107p) had met at diagnosis. Inclusion ratio in CT was similar to general population (39p, 26%). 29p (20%) underwent PCI. In OS Cox model, respiratory failure (HR: 1.9, p=0.005), and met disease at diagnosis (HR 2.4 p<0.001) were associated with worse outcomes. p included in CT had longer median OS than those not eligible to CT (15.2m vs 8.4m HR 0.7 p=0.006).

Conclusions

This large cohort captures the scenario of daily management of SCLC p in the last 10 years and confirms his poor OS. This information is necessary to better understand the evolution of SCLC in clinical practice and as background for evaluation of new strategies to improve outcomes in this disease.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

A. Navarro: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: Oryzon Genomics; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Bristol-Myers Squibb; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Merck Sharp & Dohme; Travel/Accommodation/Expenses: Boehringer Ingelheim. G. Villacampa Javierre: Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy: AstraZeneca. P. Iranzo: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Merck Sharp & Dohme; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: MSD Oncology; Advisory/Consultancy: Rovi; Advisory/Consultancy: Kyowa Kirin; Advisory/Consultancy: Grunenthal Pharma S.A.; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Bristol-Myers Squibb; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Merck Sharp & Dohme; Travel/Accommodation/Expenses: Boehringer Ingelheim; Travel/Accommodation/Expenses: Grunenthal Pharma S.A. A. Callejo: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: MSD Oncology; Advisory/Consultancy: Kyowa Kirin; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Boehringer Ingelheim; Travel/Accommodation/Expenses: MSD Oncology; Travel/Accommodation/Expenses: Celgene. N. Pardo: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Pfizer. S. Cedres: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: MSD Oncology; Advisory/Consultancy: Amphera; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Boehringer Ingelheim. A. Martinez-Marti: Advisory/Consultancy: Bristol-Myers Squibb Recipient; Advisory/Consultancy: F. Hoffmann La Roche AG; Advisory/Consultancy: Merck Sharp & Dohme; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: MSD Oncology; Speaker Bureau/Expert testimony: F. Hoffmann La Roche AG; Speaker Bureau/Expert testimony: Bristol-Myers Squibb Recipient; Speaker Bureau/Expert testimony: Merck Sharp & Dohme; Speaker Bureau/Expert testimony: Pfizer Recipient; Speaker Bureau/Expert testimony: Boehringer Ingelheim; Travel/Accommodation/Expenses: F. Hoffmann La Roche AG; Travel/Accommodation/Expenses: Bristol-Myers Squibb; Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Merck Sharp & Dohme; Travel/Accommodation/Expenses: Boehringer Ingelheim. R. Dienstmann: Advisory/Consultancy, Speaker Bureau/Expert testimony: Roche; Advisory/Consultancy: Boehringer Ingelheim; Speaker Bureau/Expert testimony: Ipsen; Speaker Bureau/Expert testimony: Amgen; Speaker Bureau/Expert testimony: Servier; Speaker Bureau/Expert testimony: Sanofi; Speaker Bureau/Expert testimony: Merck Sharp & Dohme; Research grant/Funding (self): Merck; Research grant/Funding (self): Pierre Fabre. E. Felip: Advisory/Consultancy: AbbVie; Advisory/Consultancy: AstraZeneca; Advisory/Consultancy: Blueprint medicines; Advisory/Consultancy: Boehringer Ingelheim; Advisory/Consultancy: Bristol-Myers Squibb; Advisory/Consultancy: Celgene; Advisory/Consultancy: Eli Lilly; Advisory/Consultancy: Guardant Health; Advisory/Consultancy: Janssen; Advisory/Consultancy: Medscape; Advisory/Consultancy: Merck KGaA; Advisory/Consultancy: Merck Sharp & Dohme; Advisory/Consultancy: Novartis; Advisory/Consultancy: Pfizer; Advisory/Consultancy: Roche; Advisory/Consultancy: Takeda; Advisory/Consultancy: Touchtime; Research grant/Funding (institution): Fundación Merck Salud; Research grant/Funding (institution): Grant for Oncology Innovation EMD Serono. All other authors have declared no conflicts of interest.