Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study

<i>Background and Objectives:</i> Small-cell lung cancer (SCLC) is an exceedingly aggressive neoplasm distinguished by an unfavorable prognosis. Recent studies have confirmed chemo-immunotherapy as the conventional first treatment for extensive-stage small-cell lung cancer (ES-SCLC), but...

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Main Authors: Mehmet Nuri Baser, Bilgin Demir, Gamze Serin Ozel, Gamze Gokoz Dogu, Serdar Karakaya, Mucahit Ugar, Naziye Ak, Ahmet Ozveren, Ufuk Camanlı, Olcun Umit Unal, Merve Turan, Esin Oktay
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Language:English
Published: MDPI AG 2025-07-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1230
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author Mehmet Nuri Baser
Bilgin Demir
Gamze Serin Ozel
Gamze Gokoz Dogu
Serdar Karakaya
Mucahit Ugar
Naziye Ak
Ahmet Ozveren
Ufuk Camanlı
Olcun Umit Unal
Merve Turan
Esin Oktay
author_facet Mehmet Nuri Baser
Bilgin Demir
Gamze Serin Ozel
Gamze Gokoz Dogu
Serdar Karakaya
Mucahit Ugar
Naziye Ak
Ahmet Ozveren
Ufuk Camanlı
Olcun Umit Unal
Merve Turan
Esin Oktay
author_sort Mehmet Nuri Baser
collection DOAJ
description <i>Background and Objectives:</i> Small-cell lung cancer (SCLC) is an exceedingly aggressive neoplasm distinguished by an unfavorable prognosis. Recent studies have confirmed chemo-immunotherapy as the conventional first treatment for extensive-stage small-cell lung cancer (ES-SCLC), but the impact of treatment duration remains unclear. The goal of this study was to find out how the length of treatment affected progression-free survival (PFS) and overall survival (OS) in patients with ES-SCLC who were receiving first-line atezolizumab plus chemotherapy. <i>Materials and Methods:</i> This retrospective multicenter study comprised 82 patients from six oncology centers in Turkey between 2017 and 2024. Patients were categorized into two categories according to the quantity of chemotherapy cycles they had undergone: standard treatment (≤4 cycles) and extended treatment (≥5 cycles). For the purpose of analyzing survival outcomes and related clinical determinants, as well as the demographic structures and features of the patients, both univariate and multivariate Cox regression models were utilized. <i>Results:</i> The median number of atezolizumab cycles was 8 (1–63). OS was 29.46 months after 15.8 months of follow-up, while PFS was 10.63 months. When comparing the two groups, we found no statistically significant differences in either PFS (<i>p</i> = 0.952) or OS (<i>p</i> = 0.374). Significant associations with OS were seen in the standard therapy group for both ECOG PS 1 (<i>p</i> = 0.028). Thoracic radiation considerably decreased progression risk (HR = 0.41, <i>p</i> = 0.031) in the extended group. <i>Conclusions:</i> While prolonging chemo-immunotherapy beyond four cycles did not significantly improve survival, the selected patient subgroups may benefit from personalized approaches. Thoracic radiotherapy emerged as a key modifier of outcome.
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spelling doaj-art-fe7d41645bc94f06b8efeb2d3ce2212c2025-08-20T03:07:58ZengMDPI AGMedicina1010-660X1648-91442025-07-01617123010.3390/medicina61071230Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective StudyMehmet Nuri Baser0Bilgin Demir1Gamze Serin Ozel2Gamze Gokoz Dogu3Serdar Karakaya4Mucahit Ugar5Naziye Ak6Ahmet Ozveren7Ufuk Camanlı8Olcun Umit Unal9Merve Turan10Esin Oktay11Department of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin 09010, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin 09010, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli 20160, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli 20160, TurkeyDepartment of Medical Oncology, Atatürk Sanatoryum Training and Research Hospital, Ankara 06290, TurkeyDepartment of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul 34093, TurkeyDepartment of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul 34093, TurkeyDepartment of Medical Oncology, Acıbadem Kent Hospital, Izmir 35630, TurkeyDepartment of Medical Oncology, Izmir City Hospital, Izmir 35540, TurkeyDepartment of Medical Oncology, Izmir City Hospital, Izmir 35540, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin 09010, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin 09010, Turkey<i>Background and Objectives:</i> Small-cell lung cancer (SCLC) is an exceedingly aggressive neoplasm distinguished by an unfavorable prognosis. Recent studies have confirmed chemo-immunotherapy as the conventional first treatment for extensive-stage small-cell lung cancer (ES-SCLC), but the impact of treatment duration remains unclear. The goal of this study was to find out how the length of treatment affected progression-free survival (PFS) and overall survival (OS) in patients with ES-SCLC who were receiving first-line atezolizumab plus chemotherapy. <i>Materials and Methods:</i> This retrospective multicenter study comprised 82 patients from six oncology centers in Turkey between 2017 and 2024. Patients were categorized into two categories according to the quantity of chemotherapy cycles they had undergone: standard treatment (≤4 cycles) and extended treatment (≥5 cycles). For the purpose of analyzing survival outcomes and related clinical determinants, as well as the demographic structures and features of the patients, both univariate and multivariate Cox regression models were utilized. <i>Results:</i> The median number of atezolizumab cycles was 8 (1–63). OS was 29.46 months after 15.8 months of follow-up, while PFS was 10.63 months. When comparing the two groups, we found no statistically significant differences in either PFS (<i>p</i> = 0.952) or OS (<i>p</i> = 0.374). Significant associations with OS were seen in the standard therapy group for both ECOG PS 1 (<i>p</i> = 0.028). Thoracic radiation considerably decreased progression risk (HR = 0.41, <i>p</i> = 0.031) in the extended group. <i>Conclusions:</i> While prolonging chemo-immunotherapy beyond four cycles did not significantly improve survival, the selected patient subgroups may benefit from personalized approaches. Thoracic radiotherapy emerged as a key modifier of outcome.https://www.mdpi.com/1648-9144/61/7/1230immunotherapychemotherapysmall-cell lung cancer
spellingShingle Mehmet Nuri Baser
Bilgin Demir
Gamze Serin Ozel
Gamze Gokoz Dogu
Serdar Karakaya
Mucahit Ugar
Naziye Ak
Ahmet Ozveren
Ufuk Camanlı
Olcun Umit Unal
Merve Turan
Esin Oktay
Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
Medicina
immunotherapy
chemotherapy
small-cell lung cancer
title Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
title_full Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
title_fullStr Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
title_full_unstemmed Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
title_short Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
title_sort impact of treatment duration in first line atezolizumab plus chemotherapy in extensive stage small cell lung cancer a multicenter real world retrospective study
topic immunotherapy
chemotherapy
small-cell lung cancer
url https://www.mdpi.com/1648-9144/61/7/1230
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