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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2025-01-01
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| author | 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 |
| author_facet | 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 |
| author_sort | Laura Moliner, MD |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4fc33687ab8d4162bfd96a7cd9362df2 |
| institution | Kabale University |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-4fc33687ab8d4162bfd96a7cd9362df22025-01-20T04:17:52ZengElsevierJTO Clinical and Research Reports2666-36432025-01-0161100744First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World StudyLaura Moliner, MD0Núria Zellweger, MSc1Sabine Schmid, MD2Martina Bertschinger, MD3Christine Waibel, MD4Ferdinando Cerciello, MD, PhD5Patrizia Froesch, MD6Michael Mark, MD7Adrienne Bettini, MD8Pirmin Häuptle, MD9Veronika Blum, MD10Lisa Holer, MSc11Stefanie Hayoz, PhD12Martin Früh, MD13Samreen Ahmed, FRCP, MD, MBBS, MSc14Shradha Bhagani, MD15Nicola Steele, MD16Hannah-Leigh Gray, BSc17Stephen D. Robinson, MD18Michael Davidson, MD (Res)19Samantha Cox, MD, MSc, MBBCh20Taha Khalid, MD21Tom R. Geldart, MD22Luke Nolan, FRCS, PhD23Deborah C. Scott, MBChB (MRCP)24Lindsay Hennah, MD25Tom Newsom-Davis, MD, PhD26Emma Rathbone, MD, PhD27Catherine Handforth, MD28Arshi Denton, MD29Shairoz Merchant, PhD30Fiona Blackhall, MD, PhD31Laetitia A. Mauti, MD32Raffaele Califano, MD33Sacha I. Rothschild, MD, PhD34Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United KingdomDepartment of Medical Oncology, University Hospital Basel, Basel, SwitzerlandDepartment of Medical Oncology, Inselspital, University Hospital Bern, Bern, SwitzerlandDepartment of Medical Oncology, Cantonal Hospital Winterthur, Winterthur, SwitzerlandCenter Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Baden, Baden, SwitzerlandDepartment of Medical Oncology, Inselspital, University Hospital Bern, Bern, SwitzerlandOncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, SwitzerlandDivision of Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Graubünden, Chur, SwitzerlandDepartment of Oncology, HFR Fribourg – Hôpital fribourgeois, Fribourg, SwitzerlandOncology/Hematology, Department Internal Medicine, Cantonal Hospital Baselland, Liestal, SwitzerlandDepartment of Oncology, Cantonal Hospital Lucerne, Lucerne, SwitzerlandSwiss Group for Clinical Cancer Research (SAKK), Competence Center, Bern, SwitzerlandSwiss Group for Clinical Cancer Research (SAKK), Competence Center, Bern, SwitzerlandDepartment of Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, SwitzerlandLeicester Royal Infirmary - University Hospitals of Leicester NHS Trust, Leicester, United KingdomLeicester Royal Infirmary - University Hospitals of Leicester NHS Trust, Leicester, United KingdomMedical Oncology Department, Beatson West of Scotland Cancer Centre NHS, Greater Glasgow and Clyde, Glasgow, United KingdomMedical Oncology Department, Beatson West of Scotland Cancer Centre NHS, Greater Glasgow and Clyde, Glasgow, United KingdomClinical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, United KingdomMedical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, United KingdomClinical Oncology Department, Velindre Cancer Centre - Velindre NHS University Trust - NHS Wales, Cardiff, United KingdomOncology Department, University Hospitals Dorset NHS Foundation Trust, Poole, United KingdomOncology Department, University Hospitals Dorset NHS Foundation Trust, Poole, United KingdomOncology Department, University Hospital Southampton- NHS Foundation Trust, Southampton, United KingdomOncology Department, University Hospital Southampton- NHS Foundation Trust, Southampton, United KingdomMedical Oncology Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United KingdomMedical Oncology Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United KingdomOncology Department, Huddersfield Royal Infirmary - Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United KingdomOncology Department, Huddersfield Royal Infirmary - Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United KingdomOncology Department, Northwick Park Hospital - London North West University Healthcare NHS Trust, Harrow, Middlesex, United KingdomOncology Department, Northwick Park Hospital - London North West University Healthcare NHS Trust, Harrow, Middlesex, United KingdomDepartment Of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, United KingdomDepartment of Medical Oncology, Cantonal Hospital Winterthur, Winterthur, SwitzerlandDepartment Of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, United KingdomDepartment of Medical Oncology, University Hospital Basel, Basel, Switzerland; Center Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland; Corresponding author. Address for correspondence: Sacha I. Rothschild, MD, PhD, Department of Oncology and Hematology, Cantonal Hospital, Im Ergel 1, Baden 5404, Switzerland.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.http://www.sciencedirect.com/science/article/pii/S2666364324001140SCLCReal-world dataImmunotherapySpecial populations |
| spellingShingle | 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 First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study JTO Clinical and Research Reports SCLC Real-world data Immunotherapy Special populations |
| title | First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study |
| title_full | First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study |
| title_fullStr | First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study |
| title_full_unstemmed | First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study |
| title_short | First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study |
| title_sort | first line chemo immunotherapy in sclc outcomes of a binational real world study |
| topic | SCLC Real-world data Immunotherapy Special populations |
| url | http://www.sciencedirect.com/science/article/pii/S2666364324001140 |
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