Abstract 307P
Background
Chemoimmunotherapy (CIT) with atezolizumab or durvalumab has been the standard of care first-line (1L) treatment for extensive-stage SCLC (ES-SCLC) since 3/2019. This study describes real-world overall survival (rwOS) and mortality risk factors in 1L CIT treated ES-SCLC patients (pts) in the US.
Methods
Komodo Research Data were used to identify adults with ESSCLC treated with 1L CIT from 3/2019–9/2023. In the absence of disease type/stage, SCLC vs NSCLC was differentiated based on 1L treatment regimen; pts with 1L CIT were inferred to have ES-SCLC. Demographic and clinical characteristics were described on and ±3 months of index date (1L CIT initiation), respectively. rwOS was assessed from index date among pts with ≥12 months of potential observation with the Kaplan-Meier method. Mortality risk factors were assessed with a multivariable Cox proportional hazards model.
Results
Of 50,219 pts initiating 1L lung cancer treatment since 3/2019, 7,085 (14.1%) had SCLC. Of them, 5,452 (77.0%) received a platinum-etoposide-based 1L regimen, of whom 2,788 (51.1%) were 1L CIT treated ES-SCLC pts. 1L CIT treated ES-SCLC pts had a median age of 65 years, 49.0% were male, and most had Medicare (49.3%) or commercial (40.2%) insurance. Atezolizumab (89.4%) was the most common immunotherapy in 1L CIT. The most common comorbidities were chronic obstructive pulmonary disease (COPD; 72.3%) and cardiovascular disease (CVD; 55.5%). Distant metastases were most common in the bone (42.9%), liver (40.0%), and brain (33.6%). Among 2,251 pts included in the rwOS analysis, median (95% confidence interval) rwOS was 10.8 (10.3–11.3) months. Risk of mortality was higher among pts ≥75 years (hazard ratio [HR]=1.44), males (HR=1.16), and pts with COPD (HR=1.11) or CVD (HR=1.22) (all p < 0.05). All assessed distant metastases were associated with mortality, with the highest risk for liver metastases (HR=1.62, p < 0.01).
Conclusions
Real-world outcomes among 1L CIT treated ES-SCLC pts remain poor with median rwOS
Editorial acknowledgement
Medical writing assistance was provided by professional medical writer, Flora Chik, PhD, MWC, an employee of Analysis Group, Inc., a consulting company that has provided paid consulting services to BioNTech, which funded the development and conduct of this study.
Legal entity responsible for the study
BioNTech.
Funding
BioNTech.
Disclosure
X. Le: Financial Interests, Personal, Advisory Role, Consulting/advisory fees: BioNTech, Eli Lilly, EMD Serono (Merck KGaA), AstraZeneca, Spectrum Pharmaceutics, Novartis, Regeneron, Boehringer Ingelheim, Hengrui Therapeutics, Bayer, Teligene, Taiho, Daiichi Sankyo, Janssen, Blueprint Medicines, Sensei Biotherapeutics, SystImmune, ArriVent, Abion, BlossomHill, and AbbVie; Financial Interests, Institutional, Research Grant, Research Funding to Institution: Eli Lilly, EMD Serono, ArriVent, Dizal, Teligene, Regeneron, Janssen, ThermoFisher, Takeda, and Boehringer Ingelheim; Financial Interests, Personal, Other, Travel Support: EMD Serono, Janssen, and Spectrum Pharmaceutics. E. Serra, K. Easson, R. Bellefleur, P. Gagnon-Sanschagrin, A. Guérin: Financial Interests, Institutional, Full or part-time Employment, Analysis Group, Inc. provided paid consulting services to BioNTech (study funder): Analysis Group, Inc. S. Guenther: Financial Interests, Institutional, Full or part-time Employment: BioNTech SE; Financial Interests, Institutional, Stocks/Shares: BioNTech SE. V. Guan: Financial Interests, Institutional, Full or part-time Employment: BioNTech US Inc. A. Dashputre: Financial Interests, Institutional, Full or part-time Employment: BioNTech US Inc; Financial Interests, Institutional, Stocks/Shares: BioNTech US Inc.