Abstract 168P
Background
Understanding real-world tx patterns for LS-SCLC may provide insights on current practice and inform future tx strategies. We report results of a retrospective, observational study of pts with LS-SCLC.
Methods
Data were included from 1552 pts diagnosed with LS-SCLC from 1 Jan 2015 to 31 Dec 2020 who had received at least 1 tx and were recorded in the US Flatiron Enhanced Datamart database. Primary objectives were to describe demographics, clinical characteristics and tx patterns. Real-world OS was a secondary endpoint.
Results
Median age was 67 yrs and 61.1% of pts were >65 yrs. 57.3% were female; most were Caucasian (74.9%) and 6.2% were Black. 99.1% had a history of smoking. While all were confirmed LS-SCLC at diagnosis, 48.6% had AJCC Stage III disease and stage was not documented in 29.2%; 63.2% had WHO PS 0/1 and 23.1% missing PS. Most pts (73.6%) received chemoradiotherapy (CRT) in line with major guidelines; 7.3% had surgery (± other tx). The majority of pts received platinum-etoposide chemotherapy (CT): 88.0% (carboplatin 49.0% and cisplatin 39.0%). Among 1276 CRT or CT only pts with CT cycle information, 45.7% received 4 cycles of CT and 23.1% had >6 cycles. 38.5% of pts additionally received prophylactic cranial irradiation (PCI), including 52.8% of 305 CRT or CT only pts who had PS 0 and completed >4 CT cycles. Most Stage III pts received CRT (81.3%); surgery (± other tx) and radiotherapy (RT) alone were more common for Stage I pts (table). Overall, 2.8% of pts received immunotherapy (± other tx). Median OS in all pts was 20.3 months (95% CI 19.2–21.7); 5-yr OS rate was 21.7% (95% CI 18.9–24.7). More advanced disease stage was associated with shorter OS (table).
Table: 168P| OverallN = 1552 | Stage | ||||
|---|---|---|---|---|---|
| In = 172 | IIn = 173 | IIIn = 754 | Unknownn = 453 | ||
| Tx received, %* | |||||
| CRT | 73.6 | 47.7 | 71.1 | 81.3 | 71.5 |
| CT only | 9.7 | 4.7 | 6.4 | 9.5 | 13.2 |
| RT only | 6.4 | 8.7 | 3.5 | 4.0 | 10.6 |
| Any surgery | 7.3 | 38.4 | 15.6 | 2.1 | 0.9 |
| PCI | 38.5 | 30.8 | 48.0 | 41.8 | 32.5 |
| OS (all txs) | |||||
| Median, months95% CI | 20.319.2–21.7† | 48.936.5–58.4 | 33.526.5–50.8 | 18.516.8–20.3 | 17.014.3–19.5 |
| 5-yr, %95% CI | 21.718.9–24.7 | 37.625.9–49.3 | 33.023.5–42.9 | 20.316.4–24.5 | 13.910.0–18.5 |
Other: CRT + IO (1.0%), CT + IO (0.7%), other systemic tx ± RT (1.4%).
†Median OS (95% CI) was 20.6 (19.4–21.9), 7.5 (6.4–10.0), 25.8 (18.5–46.4) and 67.2 (48.9–not estimable) for pts who received CRT, CT, RT or surgery; and 32.9 (29.0–38.6) and 14.6 (13.4–16.2) for pts who did or did not receive PCI.
Conclusions
Demographics and clinical characteristics were consistent with the known epidemiology of LS-SCLC; survival outcomes with established tx approaches in these pts remain unchanged. These outcomes demonstrate a clear unmet need, and new therapeutic strategies in LS-SCLC are warranted.
Editorial acknowledgement
Medical writing support for the development of the abstract, under the direction of the authors, was provided by Connor Keating of Ashfield MedComms (Manchester, UK) an Inizio company, and funded by AstraZeneca.
Legal entity responsible for the study
AstraZeneca PLC.
Funding: AstraZeneca.
Disclosure
A.C. Chiang: Financial Interests, Personal, Other, Honoraria: AstraZeneca, Regeneron, GNE; Financial Interests, Personal, Research Grant: BMS, AbbVie, Amgen, GNE. R.J. Salomonsen: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. A. Wang: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. R. Holland: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. L. Cai: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. Y. Xiao: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. S. Sadow: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. K. Davey: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. P. Iyengar: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Research Grant, Grants/Funds: Incyte.