A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada

Elegbede, A.; Gibson, Allan W.; Fung, A.; Cheung, Winson Y.; Dean, Michelle L.; Bebb, D. Gwyn; Pabani, Aliyah

doi:10.1016/j.jtocrr.2021.100249

Cited by 19 publications

(18 citation statements)

References 23 publications

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“… 24 Actually, similar outcomes to those in the present study have been observed in recent retrospective observational studies of chemoimmunotherapy for lung cancer. 25 , 26 , 27 Collectively, these results suggest comparable outcomes to those in clinical trials, while safety is somewhat inferior in clinical practice settings in which patients with lung cancer receive chemoimmunotherapy. However, the external validity of previous clinical trial results could not be fully investigated in these previous retrospective studies, as patients who met the eligibility criteria of clinical trials were expected to have similar outcomes to those in pivotal clinical trials, even in clinical practice settings.…”

Section: Discussionmentioning

confidence: 68%

Outcomes of Chemoimmunotherapy Among Patients With Extensive-Stage Small Cell Lung Cancer According to Potential Clinical Trial Eligibility

et al. 2023

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ImportanceChemoimmunotherapy is the standard first-line therapy for patients with extensive-stage small cell lung cancer (ES-SCLC). However, whether findings from pivotal trials can be extrapolated to the clinical practice setting remains unclear.ObjectiveTo compare treatment outcome gaps following first-line chemoimmunotherapy for patients with ES-SCLC between those who met and did not meet the eligibility criteria used in previous clinical trials.Design, Setting, and ParticipantsA prospective cohort study was conducted from September 1, 2019, to September 30, 2020, at 32 hospitals in Japan, with at least 12 months of follow-up. Participants included consecutive patients with ES-SCLC who received carboplatin and etoposide with atezolizumab as first-line therapy.ExposuresPatients who met eligibility criteria for pivotal phase 3 clinical trials were considered trial-eligible.Main Outcomes and MeasuresThe primary outcome was 6-month progression-free survival. The secondary outcomes were differences in progression-free survival, overall survival, and safety according to whether key clinical trial eligibility criteria were met.ResultsA total of 207 patients were analyzed (median age, 72 years; range, 46-87 years; 170 [82%] were male). Sixty-four patients (31%) were older adults (age ≥75 years), and most (184 [89%]) had an Eastern Cooperative Oncology Group performance status of 0 or 1. There were 132 (64%) trial-eligible patients. The 6-month progression-free survival rate for all patients was 38.8% (95% CI, 32.4%-45.7%). The median progression-free survival was 5.1 months in trial-eligible patients and 4.7 months in trial-ineligible patients (hazard ratio, 0.72; 95% CI, 0.53-0.97; P = .03). The proportion of patients who achieved disease control was 93% (118 of 127) in trial-eligible patients and 77% (55 of 71) in trial-ineligible patients (P = .002). The median overall survival was 15.8 months in trial-eligible patients and 13.1 months in trial-ineligible patients (hazard ratio, 0.73; 95% CI, 0.51-1.07; P = .10). The rate of severe adverse events was numerically higher among trial-ineligible patients than among trial-eligible patients (39% vs 27%; P = .07).Conclusions and RelevanceIn this cohort study, the overall treatment outcome was comparable to that reported in pivotal clinical trials. However, treatment outcomes after chemoimmunotherapy might differ between trial-eligible and trial-ineligible patients. These findings suggest that trial-eligibility criteria may be useful in clinical practice, and further studies using data from clinical practice settings are required to inform regulatory approval and clinical decision-making.

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Section: Discussionmentioning

confidence: 68%

Outcomes of Chemoimmunotherapy Among Patients With Extensive-Stage Small Cell Lung Cancer According to Potential Clinical Trial Eligibility

et al. 2023

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“… 10 In a retrospective data analysis, chemotherapy plus atezolizumab for patients with ES-SCLC with a PS of more than or equal to 2 was reported to be feasible; however, the OS was short, which is consistent with our present observations. 23 …”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Programmed Death-Ligand 1 Inhibitor Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC: A Prospective Observational Study

Morimoto

Yamada

Takeda

et al. 2022

JTO Clinical and Research Reports

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“…In addition, three patients from group A developed radiation pneumonitis, which was classified as grade 2 in two patients and grade 1 in one patient. [5,6], and two recent real-world evaluations [8,9]. The median PFS and OS for the IMpower 133 study were 5.2 and 12.3 months, respectively [5].…”

Section: Subgroup Analysis Based On Radiation Treatmentmentioning

confidence: 99%

“…To our knowledge, only two real-world studies have confirmed the beneficial effects of adding atezolizumab to chemotherapy in the treatment of ES-SCLC [8,9]. Given this paucity of data, we believe that the evaluation of retrospective data may help further evaluate immunotherapy in patients with ES-SCLC.…”

Section: Introductionmentioning

confidence: 99%

Real-world evaluation of atezolizumab and etoposide-carboplatin as a first-line treatment for extensive-stage small cell lung cancer

Kim

Mok

et al. 2023

Korean J Intern Med

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Background/Aims: Despite the obvious benefits of adding immune checkpoint inhibitors to platinum-etoposide chemotherapy in patients with extensive-stage small-cell lung cancer (ES-SCLC), real-world data remain scarce.Methods: This retrospective study included 89 patients with ES-SCLC treated with platinum-etoposide chemotherapy alone (chemo-only group; n = 48) or in combination with atezolizumab (atezolizumab group; n = 41) and compared the survival outcomes between these two groups.Results: Overall survival (OS) was significantly longer in the atezolizumab group than in the chemo-only group (15.2 months vs. 8.5 months; p = 0.047), whereas the median progression-free survival was almost the same (5.1 months vs. 5.0 months) in both groups (p = 0.754). Subsequent multivariate analysis revealed that thoracic radiation (hazard ratio [HR], 0.223; 95% confidence interval [CI], 0.092–0.537; p = 0.001) and atezolizumab administration (HR, 0.350; 95% CI, 0.184–0.668; p = 0.001) were favorable prognostic factors for OS. In the thoracic radiation subgroup, patients who received atezolizumab demonstrated favorable survival outcomes and no grade 3–4 adverse events (AEs).Conclusions: The addition of atezolizumab to platinum-etoposide resulted in favorable outcomes in this real-world study. Thoracic radiation was associated with improved OS and acceptable AE risk in combination with immunotherapy in patients with ES-SCLC.

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A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada

Cited by 19 publications

References 23 publications

Outcomes of Chemoimmunotherapy Among Patients With Extensive-Stage Small Cell Lung Cancer According to Potential Clinical Trial Eligibility

Outcomes of Chemoimmunotherapy Among Patients With Extensive-Stage Small Cell Lung Cancer According to Potential Clinical Trial Eligibility

Efficacy and Safety of Programmed Death-Ligand 1 Inhibitor Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC: A Prospective Observational Study

Real-world evaluation of atezolizumab and etoposide-carboplatin as a first-line treatment for extensive-stage small cell lung cancer

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