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. 2022 May;71(5):1093-1101.
doi: 10.1007/s00262-021-03052-w. Epub 2021 Sep 27.

Efficacy and safety of atezolizumab, in combination with etoposide and carboplatin regimen, in the first-line treatment of extensive-stage small-cell lung cancer: a single-center experience

Seoyoung Lee  1 , Hyo Sup Shim  2 , Beung-Chul Ahn  3 , Sun Min Lim  3 , Hye Ryun Kim  3 , Byoung Chul Cho  3 , Min Hee Hong  4
Affiliations

Efficacy and safety of atezolizumab, in combination with etoposide and carboplatin regimen, in the first-line treatment of extensive-stage small-cell lung cancer: a single-center experience

Seoyoung Lee et al. Cancer Immunol Immunother. 2022 May.

Abstract

Background: Patients with small-cell lung cancer (SCLC) have a dismal prognosis with limited overall survival (OS) despite a high response rate to chemotherapy. Recently, immune checkpoint inhibitors, combined with chemotherapy, as the first-line treatment for extensive-stage (ES)-SCLC have shown improvement in clinical outcomes.

Patients and methods: Real-world data from 68 Korean ES-SCLC patients, treated with atezolizumab, etoposide, and carboplatin at Yonsei Cancer Center between June 2019 and November 2020, were retrospectively analyzed to determine safety and efficacy using Cox regression analysis.

Results: The median follow-up was 11.6 months. The median progression-free survival was 4.6 months (95% confidence interval [CI] 4.0-5.2), and the median OS was 12.0 months (95% CI 7.4-16.6). Baseline bone metastasis, immune-related adverse events (IRAEs), and elevated LDH were related to OS (hazard ratio 2.18, 0.33, and 4.64; P = 0.05, 0.02, and 0.003, respectively). Among the 42 patients with disease progression, liver metastasis progression and baseline bone metastasis were associated with inferior OS, but without statistical significance (hazard ratio 2.47 and 1.97; P = 0.25 and 0.26, respectively). Overall, 61 (89.7%) patients experienced treatment-related adverse events (TRAEs), with hematologic toxicities as the most common grade 3-4 TRAEs. Twenty-two (32.4%) patients experienced IRAEs, with skin rash as the most common, and five (7.4%) patients had grade-3 IRAEs (pneumonitis, hyperglycemia, and aspartate aminotransferase elevation).

Conclusion: Atezolizumab, combined with etoposide and carboplatin, showed efficacy and safety in our real-world data. Further studies are needed to predict the response to immunotherapy in SCLC.

Keywords: Asian; IMpower133 Study; Immunotherapy; Korea; Real-world data.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Survival of total patients. The Kaplan–Meier estimates of a progression-free survival and b overall survival of total patients (N = 68) are shown (tick marks: censored data). CI confidence interval
Fig. 2
Fig. 2
Treatment outcomes. a Swimmer plot of patients with measurable lesions who had at least one response evaluation (N = 60). Time to first response, disease progression, death, and the duration of treatment are shown. b Waterfall plot of patients with measurable lesions who had at least one response evaluation (N = 60). Maximum percent change in tumor size from baseline is shown according to best response. CR complete response, PR partial response, SD stable disease, PD progressive disease
Fig. 3
Fig. 3
Metastases sites. a Baseline metastases sites of patients before treatment. b Progression sites after treatment with atezolizumab, etoposide, and carboplatin
See this image and copyright information in PMC

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