Multicenter retrospective study on the clinical profiles of patients with extensive-stage small-cell lung cancer who met the eligibility criteria for clinical trials.

BACKGROUND

Chemoimmunotherapy is the standard first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC); however, a limited number of real-world cases meet the inclusion and exclusion criteria of clinical trials. This study investigated whether chemoimmunotherapy is selected in patients with ES-SCLC who meet eligibility criteria in real-world practice and identified their clinical characteristics.

METHODS

A total of 198 patients diagnosed with ES-SCLC received first-line treatment at 11 institutions between August 2019 and June 2023. We evaluated the efficacy and safety of first-line treatment in patients meeting the eligibility criteria of the IMpower133 and CASPIAN trials. This multicenter retrospective study included 78 patients (39.4%) who met the eligibility criteria.

RESULTS

Fifty-six (71.8%) and twenty-two (28.2%) underwent chemoimmunotherapy and chemotherapy, respectively. The proportion of patients aged ≥75 years was higher in the chemotherapy group. The median progression-free survival in the chemoimmunotherapy and chemotherapy groups was 5.1 versus 4.6 months (hazard ratio [HR] 0.50; 95% confidence interval [CI], 0.29-0.84), respectively. The median overall survival in the chemoimmunotherapy and chemotherapy groups was 17.1 versus 9.4 months (HR 0.51; 95% CI, 0.29-0.88), respectively. The discontinuation rate of treatment-related adverse events did not differ significantly between the two groups (5.4% vs. 0.0%, p = 0.555).

CONCLUSION

First-line chemoimmunotherapy is considered a valuable treatment option for patients with ES-SCLC who meet the eligibility criteria for clinical trials. However, even among eligible patients, chemotherapy alone may be selected based on various reasons, such as older age. Furthermore, a comprehensive analysis of real-world data is required.

TRIAL REGISTRATION: This study was registered in the UMIN Clinical Trial Registry (A multicenter retrospective study to evaluate the efficacy and safety of platinum-based chemotherapy in combination with immunotherapy for extensive-stage small cell lung cancer in the real-world setting, UMIN000053134).