Cancer Res Treat.  2024 Apr;56(2):422-429. 10.4143/crt.2023.913.

The Real-World Outcome of First Line Atezolizumab in Extensive-Stage Small Cell Lung Cancer: A Multicenter Prospective Cohort Study

• Choi MG
• Kim YJ
• Lee JC
• Ji W
• Oh IJ
• Lee SY
• Yoon SH
• Lee SY
• Lee JE
• Kim EY
• Choi CM

• KMID: 2554333
• DOI: http://doi.org/10.4143/crt.2023.913

Abstract

Purpose
The addition of immune checkpoint inhibitors to chemotherapy has improved survival outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). However, their real-world effectiveness remains unknown. Therefore, we investigated the effectiveness of atezolizumab plus chemotherapy in ES-SCLC in actual clinical settings.
Materials and Methods
In this multicenter prospective cohort study, patients with ES-SCLC receiving or scheduled to receive atezolizumab in combination with etoposide and carboplatin were enrolled between June 2021 and August 2022. The primary outcomes were progression-free survival (PFS) and the 1-year overall survival (OS) rate.
Results
A total of 100 patients with ES-SCLC were enrolled from seven centers. Median age was 69 years, and 6% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2. The median PFS was 6.0 months, the 1-year OS rate was 62.2%, and the median OS was 13.5 months. An ECOG PS of 2-3 and progressive disease as the best response were poor prognostic factors for PFS, while an ECOG PS of 2-3 and brain metastasis were associated with poor prognosis for OS. In addition, consolidative thoracic radiotherapy was found to be an independent favorable prognostic factor for OS (hazard ratio, 0.336; p=0.021). Grade ≥ 3 treatment-related adverse events were observed in 7% of patients, with treatment-related deaths occurring in 2% of patients.
Conclusion
We provided evidence of the favorable real-world effectiveness and safety of atezolizumab plus chemotherapy in ES-SCLC patients, including in the elderly and those with poor ECOG PS. Additional consolidative thoracic radiotherapy may also benefit ES-SCLC patients.

Keyword

Atezolizumab; Real-world; Small cell lung carcinoma

Figure

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  Fig. 1. Flowchart of patients with small cell lung cancer receiving atezolizumab plus chemotherapy. ES-SCLC, extensive-stage small cell lung cancer.

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  Fig. 2. Progression-free survival (PFS) (A) and overall survival (OS) (B) for all patients with small cell lung cancer receiving atezolizumab plus chemotherapy. IQR, interquartile range; N/E, not evaluable.

Reference

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