Abstract 147P
Background
Extensive-stage small cell lung cancer (ES-SCLC) is still characterized by a poor prognosis. The recent introduction of concomitant immunotherapy (IT) allowed to obtain better results in terms of clinical outcomes without increasing toxicity,while the role of thoracic radiotherapy (TRT) is still largely unknown in this setting. The aim of our study was to evaluate clinical outcome and safety of chemo-immunotherapy (CT-IT) with or without consolidative TRT in ES-SCLC.
Methods
Thirty-one pts treated from February 2020 to October 2021 were retrospectively reviewed. Median age was 66 yrs. Twenty-one were male, 10 female. All pts treated had ES-SCLC.Overall survival (OS) and progression free survival (PFS) were analyzed using the Kaplan Meier method. Univariate analysis was performed to investigate patient, tumor, treatment related prognostic factors influencing clinical outcomes.Toxicity was recorded based on CTCAE 4.0 scale.
Results
At a median follow up of 6 months, 31 patients were treated using first-line platinum-based CT-IT. Twenty-two pts also received maintenance atezolizumab after CT-IT. Consolidative TRT was delivered to 7 responding patients and 2 patients underwent cranioprophylactic RT. Median and estimated 1-year OS was 7.7 months and 33.3%, respectively. Median and estimated 1-yr PFS was 5.4 months and 37,1%, respectively. At univariate analysis TRT, PS ECOG=0 and no brain metastases (MTS) were positive statistically significant prognostic factors in terms of PFS and OS. Toxicity >G2 was reported in 11 patients: neutropenia was the most common followed by thrombocytopenia, gastrointestinal and hepatic toxicity. No significant differences in terms of symptomatic side effects was found between who did or did not undergo TRT.
Conclusions
CT-IT is an effective therapeutic option for ES-SCLC patients. In our analysis PFS was comparable to the randomized registration trials. Safety and tolerance are satisfactory, also when consolidative TRT was added. TRT is feasible also in the CT-IT era and might positively affect outcome. Controlled conditions,longer follow up and larger patient cohorts are now needed to further assess the impact of TRT on local control and survival.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.