First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study

First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study

Introduction: SCLC is characterized by aggressiveness and limited treatment options, especially in extensive-stage SCLC (ES-SCLC). Immunotherapy added to the platinum-etoposide combination has recently become standard in this setting. This retrospective study aims to evaluate the real-world effectiv...

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Main Authors: Laura Moliner, MD, Núria Zellweger, MSc, Sabine Schmid, MD, Martina Bertschinger, MD, Christine Waibel, MD, Ferdinando Cerciello, MD, PhD, Patrizia Froesch, MD, Michael Mark, MD, Adrienne Bettini, MD, Pirmin Häuptle, MD, Veronika Blum, MD, Lisa Holer, MSc, Stefanie Hayoz, PhD, Martin Früh, MD, Samreen Ahmed, FRCP, MD, MBBS, MSc, Shradha Bhagani, MD, Nicola Steele, MD, Hannah-Leigh Gray, BSc, Stephen D. Robinson, MD, Michael Davidson, MD (Res), Samantha Cox, MD, MSc, MBBCh, Taha Khalid, MD, Tom R. Geldart, MD, Luke Nolan, FRCS, PhD, Deborah C. Scott, MBChB (MRCP), Lindsay Hennah, MD, Tom Newsom-Davis, MD, PhD, Emma Rathbone, MD, PhD, Catherine Handforth, MD, Arshi Denton, MD, Shairoz Merchant, PhD, Fiona Blackhall, MD, PhD, Laetitia A. Mauti, MD, Raffaele Califano, MD, Sacha I. Rothschild, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:JTO Clinical and Research Reports
Subjects:
SCLC
Real-world data
Immunotherapy
Special populations
Online Access:http://www.sciencedirect.com/science/article/pii/S2666364324001140
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Summary:Introduction: SCLC is characterized by aggressiveness and limited treatment options, especially in extensive-stage SCLC (ES-SCLC). Immunotherapy added to the platinum-etoposide combination has recently become standard in this setting. This retrospective study aims to evaluate the real-world effectiveness of chemo-immunotherapy in patients with ES-SCLC, focusing on subpopulations excluded from clinical trials. Methods: A retrospective binational multicenter study was conducted, involving consecutive patients with ES-SCLC from 10 British and 10 Swiss institutions. Patients received platinum-etoposide chemotherapy in combination with immunotherapy (atezolizumab or durvalumab). Patient, tumor, and treatment details were collected. Overall survival (OS), progression-free survival, objective response rate, and safety outcomes were analyzed. Results: A total of 436 patients were included. One hundred forty-two patients (32.6%) in our cohort would not have been eligible for the pivotal registrational trials owing to an Eastern Cooperative Oncology Group performance status of 2 or higher, autoimmune disease, active brain metastases, or steroid use. Most patients received carboplatin (96.8%) and atezolizumab (97.9%). The median progression-free survival was 5.5 months and the median OS was 9.3 months. The two-year OS was 14%. Patients with liver or bone metastases or an Eastern Cooperative Oncology Group performance status of 2 or higher had worse survival outcomes. Treatment-related adverse events were reported in 222 patients (51%) whereas immune-related adverse events occurred in 95 patients (22%). Three out of five grade 5 immune-related adverse events were caused by pneumonitis. Conclusions: To our knowledge, this is the largest real-world cohort of patients treated with chemo-immunotherapy for ES-SCLC. Although one-third of patients would not have been eligible for pivotal trials, the survival outcomes in our cohort are similar to those in registrational trials. In particular, the number of long-term survivors and the safety data are comparable, supporting the use of chemo-immunotherapy as first-line treatment for ES-SCLC in daily clinical practice.
ISSN:2666-3643

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