ONCOmmunity

Long-term effectiveness and treatment sequences in patients with extensive stage small cell lung cancer receiving atezolizumab plus chemotherapy: Results of the IFCT-1905 CLINATEZO real-world study.

By: Lionel Falchero, Florian Guisier, Marie Darrason, Arnaud Boyer, Charles Dayen, Sophie Cousin, Patrick Merle, Régine Lamy, Anne Madroszyk, Josiane Otto, Pascale Tomasini, Sandra Assoun, Anthony Canellas, Radj Gervais, José Hureaux, Jacques Le Treut, Olivier Leleu, Charles Naltet, Marie Tiercin, Sylvie Van Hulst, Pascale Missy, Franck Morin, Virginie Westeel, Nicolas Girard

Service de Pneumologie et Cancérologie Thoracique, Hôpitaux Nord-Ouest, Villefranche Sur Saône, France.
2023-5-23; doi: 10.1016/j.lungcan.2023.107379

Abstract

Background

Small cell lung cancer (SCLC) has a tendency towards recurrence and limited survival. Standard-of-care in 1st-line is platinum-etoposide chemotherapy plus atezolizumab or durvalumab,based on landmarkclinical trials.

Methods

IFCT-1905 CLINATEZO is a nationwide, non-interventional, retrospectivestudy of patients with extensive-SCLC receivingatezolizumab plus chemotherapy as part of French Early Access Program. Objectives were to analyse effectiveness,safetyand subsequent treatments.

Results

The population analyzed included 518 patients who received atezolizumab in 65 participating centers. There were 66.2% male,mean age was 65.7 years; 89.1% had a performance status (PS) 0/1 and 26.6% brain metastases. Almost all(95.9%) were smokers. Fifty-five (10.6%) received at least 1 previous treatment. Median number of atezolizumab injections was 7.0 (range [1.0-48.0]) for a median duration of 4.9 months (95% CI 4.5-5.1). Atezolizumab was continued beyond progression in 122 patients (23.6%) for a median duration of 1.9 months (95% CI: [1.4-2.3]). Best objective response was complete and partial in 19 (3.9%) and 378 (77.1%)patients. Stable disease was observed in 50 patients (10.2%). Median follow-up was 30.8 months (95% CI: [29.9-31.5]). Median overall survival (OS), 12-, 24-month OS rates were 11.3 months (95% CI: [10.1-12.4]), 46.7% (95% CI [42.3-50.9]) and 21.2% (95% CI [17.7-24.8]). Median real-world progression-free survival, 6-, 12-month rates were 5.2 months (95% CI [5.0-5.4]), 37.5% (95% CI [33.3-41.7]) and 15.2% (95% CI [12.2-18.6]). For patients with PS 0/1, median OS was 12.2 months (95% CI [11.0-13.5]). For patients with previous treatment, median OS was 14.9 months (95% CI [10.1-21.5]). Three-hundred-and-twenty-six patients(66.4%) received subsequent treatment and 27 (5.2%) were still under atezolizumab at date of last news.

Conclusions

IFCT-1905 CLINATEZO shows reproductibility, in real-life,of IM power-133 survival outcomes, possibly attributed to selection of patients fit for this regimen, adoption of pragmatic approaches,including concurrent radiotherapy and treatment beyond progression.