Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2024 Apr;56(2):422-429. doi: 10.4143/crt.2023.913. Epub 2023 Oct 23.
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.
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.
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.
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.
免疫检查点抑制剂联合化疗提高了广泛期小细胞肺癌（ES-SCLC）患者的生存结局。然而，其真实世界的疗效仍不清楚。因此，我们研究了阿替利珠单抗联合化疗在 ES-SCLC 中的实际临床疗效。
这是一项多中心前瞻性队列研究，纳入了 2021 年 6 月至 2022 年 8 月期间接受或计划接受阿替利珠单抗联合依托泊苷和卡铂治疗的 ES-SCLC 患者。主要结局为无进展生存期（PFS）和 1 年总生存期（OS）率。
共纳入了来自 7 家中心的 100 例 ES-SCLC 患者。中位年龄为 69 岁，6%的患者的东部肿瘤协作组体力状况（ECOG PS）≥2。中位 PFS 为 6.0 个月，1 年 OS 率为 62.2%，中位 OS 为 13.5 个月。ECOG PS 为 2-3 分和最佳疗效为进展是 PFS 的不良预后因素，而 ECOG PS 为 2-3 分和脑转移与 OS 不良相关。此外，巩固性胸部放疗是 OS 的独立预后良好因素（风险比，0.336；p=0.021）。7%的患者发生了≥3 级治疗相关不良事件，2%的患者发生了治疗相关死亡。
我们提供了阿替利珠单抗联合化疗在 ES-SCLC 患者中具有良好的真实世界疗效和安全性的证据，包括在老年患者和 ECOG PS 较差的患者中。额外的巩固性胸部放疗也可能使 ES-SCLC 患者获益。
