Treatment patterns and survival outcomes for small-cell lung cancer patients – a Swedish single center cohort study

Abstract

Objectives: This real-world study on small-cell lung cancer (SCLC) patients aimed to investigate treatment patterns, outcome of re-challenge with platinum doublet chemotherapy (PDCT), and associations between clinical characteristics and survival outcomes.

Real-World Treatment Patterns, Clinical Outcomes, and Health Care Resource Utilization in Extensive-Stage Small Cell Lung Cancer in Canada

“…Immunotherapies (atezolizumab [15] and durvalumab [16]) in addition to platinum-etoposide combination therapy have been evaluated in clinical trials and have shown significant improvements in survival outcomes [17]. Of the patients who initiated first-line therapy in this study, 92.5% received a platinum-etoposide combination therapy, and this is consistent with several studies conducted in Europe and Canada [7][8][9][10]. It is reasonable to suppose that the majority of ES-SCLC patients well enough to embark on platinum-doublet chemotherapy would be eligible to receive these novel first-line therapies in a real-world setting.…”

“…Of the patients who initiated chemotherapy (46.5%) in this study, only 18.7% initiated second-line therapy, and 3.0% initiated third-line therapy. The low initiation of second-and third-line therapy is consistent with other population-based studies that have comprehensively examined treatment patterns in ES-SCLC conducted in the Netherlands, Sweden, Germany, and Canada [7][8][9][10]. The low initiation of subsequent lines of therapy highlights the importance of novel first-line therapies that are well tolerated and have a durable response.…”

“…In the first-line setting, the majority of patients received either carboplatin plus etoposide (49.5%) or cisplatin plus etoposide (43.0%), which is in line with Canadian guidelines that recommend platinum-based doublet chemotherapy. The similar preference between cisplatin and carboplatin is unique, since elsewhere in the world there seems to be a considerably larger preference for carboplatin over cisplatin [8][9][10]. However, the use of carboplatin was higher in this study compared to that in a study conducted on an earlier cohort in Manitoba [6], which could be evidence that the balance between cisplatin and carboplatin may slowly be shifting towards carboplatin in Canada.…”

“…To date, few studies have comprehensively examined multiple lines of therapy and associated outcomes in a large population-based real-world setting [5]. Of the studies that have examined multiple lines of therapy, the majority were contained to a single centre [7,8] and/or did not include untreated patients [8][9][10] or recurrent cases of ES-SCLC [7][8][9][10]. As such, there is a paucity of information on treatment patterns and long-term survival among patients with ES-SCLC in Canada.…”

Real‐world treatment patterns and outcomes of patients with extensive disease small cell lung cancer

“…(2019) and the cohort study of Tendler et al. (2020) are the only other recent studies including such data. Our findings are in line with Steffens et al with regard to low percentages of patients receiving a second and third‐line.…”