First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study

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

JTO Clinical and Research Reports (Jan 2025)

First-Line Chemo-Immunotherapy in SCLC: Outcomes of a Binational Real-World Study

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

Affiliations

Laura Moliner, MD: Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
Núria Zellweger, MSc: Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
Sabine Schmid, MD: Department of Medical Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
Martina Bertschinger, MD: Department of Medical Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
Christine Waibel, MD: Center Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland
Ferdinando Cerciello, MD, PhD: Department of Medical Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
Patrizia Froesch, MD: Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
Michael Mark, MD: Division of Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Graubünden, Chur, Switzerland
Adrienne Bettini, MD: Department of Oncology, HFR Fribourg – Hôpital fribourgeois, Fribourg, Switzerland
Pirmin Häuptle, MD: Oncology/Hematology, Department Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
Veronika Blum, MD: Department of Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
Lisa Holer, MSc: Swiss Group for Clinical Cancer Research (SAKK), Competence Center, Bern, Switzerland
Stefanie Hayoz, PhD: Swiss Group for Clinical Cancer Research (SAKK), Competence Center, Bern, Switzerland
Martin Früh, MD: Department of Oncology and Hematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
Samreen Ahmed, FRCP, MD, MBBS, MSc: Leicester Royal Infirmary - University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Shradha Bhagani, MD: Leicester Royal Infirmary - University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Nicola Steele, MD: Medical Oncology Department, Beatson West of Scotland Cancer Centre NHS, Greater Glasgow and Clyde, Glasgow, United Kingdom
Hannah-Leigh Gray, BSc: Medical Oncology Department, Beatson West of Scotland Cancer Centre NHS, Greater Glasgow and Clyde, Glasgow, United Kingdom
Stephen D. Robinson, MD: Clinical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, United Kingdom
Michael Davidson, MD (Res): Medical Oncology Department, The Royal Marsden Hospital - NHS Foundation Trust, London, United Kingdom
Samantha Cox, MD, MSc, MBBCh: Clinical Oncology Department, Velindre Cancer Centre - Velindre NHS University Trust - NHS Wales, Cardiff, United Kingdom
Taha Khalid, MD: Oncology Department, University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
Tom R. Geldart, MD: Oncology Department, University Hospitals Dorset NHS Foundation Trust, Poole, United Kingdom
Luke Nolan, FRCS, PhD: Oncology Department, University Hospital Southampton- NHS Foundation Trust, Southampton, United Kingdom
Deborah C. Scott, MBChB (MRCP): Oncology Department, University Hospital Southampton- NHS Foundation Trust, Southampton, United Kingdom
Lindsay Hennah, MD: Medical Oncology Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
Tom Newsom-Davis, MD, PhD: Medical Oncology Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
Emma Rathbone, MD, PhD: Oncology Department, Huddersfield Royal Infirmary - Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
Catherine Handforth, MD: Oncology Department, Huddersfield Royal Infirmary - Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom
Arshi Denton, MD: Oncology Department, Northwick Park Hospital - London North West University Healthcare NHS Trust, Harrow, Middlesex, United Kingdom
Shairoz Merchant, PhD: Oncology Department, Northwick Park Hospital - London North West University Healthcare NHS Trust, Harrow, Middlesex, United Kingdom
Fiona Blackhall, MD, PhD: Department Of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
Laetitia A. Mauti, MD: Department of Medical Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
Raffaele Califano, MD: Department Of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, United Kingdom
Sacha I. Rothschild, MD, PhD: Department 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.

Journal volume & issue: Vol. 6, no. 1
p. 100744

Abstract

Read online

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.

Published in JTO Clinical and Research Reports

ISSN: 2666-3643 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.journals.elsevier.com/jto-clinical-and-research-reports/

About the journal

Abstract

Keywords