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Abstract
Introduction. Small cell lung cancer (SCLC) is characterized by an aggressive clinical course.
Aim. To evaluate the long-term outcomes of SCLC patients treated in a real-world setting with first-line platinum-etoposide chemotherapy combined with atezolizumab.
Materials and Methods. Data on 90 SCLC patients treated with carboplatin-etoposide plus atezolizumab from 2020 to 2025 were obtained from the Leningrad Regional register. Progression-free survival (PFS), overall survival (OS), and potential factors negatively impacting OS were analyzed via multivariate analysis.
Results. The median PFS (mPFS) and median OS (mOS) for the entire cohort were 6.3 and 12.4 months, respectively. A statistically significant OS difference was observed between patients with ECOG performance status 0-1 (n=59; mOS 17.1 months, 95% CI 11.9–30.0) and ECOG 2-3 (n=31; mOS 9.6 months, 95% CI 6.1–not reached), p=0.006. OS was significantly higher in patients with target lesion size <100 mm (n=25; mOS 25.7 months, 95% CI 11.9–not reached) versus those with lesions >100 mm (n=65; mOS 11.8 months, 95% CI 9.1–16.6), p=0.01. Among stage IV patients, mPFS and mOS were 6.1 and 12.4 months. Statistically significant OS differences were also seen between patients with (n=19; mOS 7.2 months, 95% CI 6.2–not reached) and without adrenal metastases (n=48; mOS 14.7 months, 95% CI 12.4–30.6), p=0.003; and between subgroups with lesion size >100 mm (n=51; mOS 12.4 months, 95% CI 7.4–16.6) versus <100 mm (n=16; mOS 21.6 months, 95% CI 11.9–not reached), p=0.04. Multivariate analysis identified the presence of adrenal metastases (HR 2.41, 95% CI 1.09–5.35, p=0.030) and ECOG status 2-3 (HR 2.30, 95% CI 1.06–4.97, p=0.034) as independent factors associated with a higher risk of death.
Conclusion. Study outcomes were comparable to those reported in the pivotal IMpower 133 trial, despite notable differences in baseline patient characteristics. The presence of adrenal metastases and poor ECOG performance status were associated with worse OS.
References
American Cancer Society. Key Statistics for Lung Cancer. (2022).-URL: https://www.cancer.net/cancer-types/lung-cancer-small-cell/statistics (21/03/2022).
Rossi A., Di Maio M., Chiodini P., et al. Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: the COCIS meta-analysis of individual patient data. J Clin Oncol. 2012; 30: 1692-8.-DOI: https://doi.org/10.1200/JCO.2011.40.4905.
Клинические рекомендации Министерства здравоохранения Российской Федерации «Злокачественное новообразование бронхов и легкого», Москва. 2022; 104.-URL: https://oncology-association.ru/wp-content/uploads/2021/02/rak-legkogo-2021.pdf. [Ministry of Health of the Russian Federation Clinical guidelines: Malignant bronchial and lung neoplasm, Moscow. 2022; 104.-URL: https://oncology-association.ru/wp-content/uploads/2021/02/rak-legkogo-2021.pdf (In Rus)].
Horn L., Mansfield A., Havel l., et al. First-Line Atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med. 2018; 379: 2220-9.-DOI: https://doi.org/10.1056/NEJMoa1809064.
Pas-Arez L., Dvorkin M., Chen Y., et al. Durvalumab plus platinum–etoposide versus platinum–etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet. 2019; 394(10212): P1929-1939.-DOI: https://doi.org/10.1016/S0140-6736(19)32222-6.
Choi M., Kim Y., Lee J., et al. The real-world outcome of first line atezolizumab in extensive-stage small cell lung cancer: A multicenter prospective cohort study. Cancer Res Treat. 2024; 56(2): 422-429.-DOI: https://doi.org/10.4143/crt.2023.913.
Miyauchi E., Nishio M., Ohashi K., et al. J-TAIL-2: A prospective, observational study of atezolizumab combined with carboplatin and etoposide in patients with extensive-stage SCLC in Japan. JTO Clin Res Rep. 2025; 6: 100783.-DOI: https://doi.org/10.1016/j.jtocrr.2024.100783.
Гамаюнов С.В., Шегурова М.М., Овчинникова Е.Г., et al. Опыт применения атезолизумаба в комбинированной терапии мелкоклеточного рака легкого: анализ собственных данных. Онкология. Журнал им. П.А. Герцена. 2022; 11 (3): 36-40.-DOI: https://doi.org/10.17116/onkolog20221103136. [Gamayunov S.V., Shegurova M.M., Ovchinnikiva E.G., et al. Experience with atezolizumab combination therapy for small cell lung cancer: analysis of the author’s own data. P.A. Herzen Journal of Oncology. 2022; 11(3): 36-40.-DOI: https://doi.org/10.17116/onkolog20221103136 (In Rus)].
Lamin M., Casas R., Azcuna J., et al. A retrospective study of first line atezolizumab-carboplatin-etoposide in extensive-stage small cell lung cancer: Real world data from a Spanish tertiary center. Jorn Clin Oncol. 2024; 42(16 suppl).-DOI: https://doi.org/10.1200/JCO.2024.42.16_suppl.e20100.
Pemberton L., Owadally W., Ayre G., et al. Real-world evaluation of atezolizumab alongside chemotherapy in extensive stage small cell lung cancer (ES-SCLC): A retrospective review from the University Hospitals Bristol and Weston (UHBW) NHS Foundation Trust. Lung Cancer. 2025; 200(Suppl 1).-DOI: https://doi.org/10.1016/j.lungcan.2025.108333.
Zhuo M., Chen H., Ma X., et al. 145P Clinical outcomes of atezolizumab in combination with etoposide/platinum for extensive-stage small cell lung cancer in China: A real-world, multi-center, retrospective, controlled study. Ann of Oncol. 2022; 33(2).-DOI: https://doi.org/10.1016/j.annonc.2022.02.176.
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