2022 World Conference on Lung Cancer (ePosters)-EP14.05-017. Real World Eligibility of Immune Checkpoint Inhibitors with Platinum-Doublet in Extensive Stage Small Cell Lung Cancer

EP14.05-017. Real World Eligibility of Immune Checkpoint Inhibitors with Platinum-Doublet in Extensive Stage Small Cell Lung Cancer

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This study focused on the real-world eligibility of using immune checkpoint inhibitors (ICI) in combination with platinum-based chemotherapy as a first-line treatment for extensive stage small cell lung cancer (SCLC). The researchers examined the data of SCLC patients referred to BC Cancer between January 2015 and December 2017.<br /><br />The study found that SCLC is a highly aggressive tumor, accounting for 13% of new lung cancer diagnoses. The current standard of care for SCLC is platinum-based chemotherapy due to its high responsiveness. However, recent trials, such as CASPIAN and IMpower133, have shown improved overall survival when ICI is added to platinum-based chemotherapy.<br /><br />Despite the observed benefits, the study also highlighted certain challenges in real-world clinical practice. Many SCLC patients have contraindications to ICI treatment, such as autoimmune conditions or uncontrolled infections, which limit their eligibility. Additionally, patients with poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) may not be suitable for platinum-based chemotherapy with ICI.<br /><br />The analysis of the real-world data revealed that 65% of extensive SCLC patients received first-line platinum doublet chemotherapy. By considering the eligibility criteria used in the CASPIAN and IMpower133 trials, only 23% of patients would be appropriate candidates for these studies. The most significant factor impacting eligibility was the ECOG PS.<br /><br />The study also observed that some patients showed improved ECOG PS after one cycle of chemotherapy, which may enable the safer delivery of platinum doublet chemotherapy and ICI.<br /><br />In conclusion, while the phase III trials have provided valuable evidence, a significant proportion of extensive SCLC patients do not meet the eligibility criteria. The authors emphasized the need for clinical trials that include patients with poor ECOG PS to address this evidence gap and inform medical practice.<br /><br />The study was supported by research grant funding from AstraZeneca and the BC Cancer Foundation.

Asset Subtitle

Rebekah Rittberg

Meta Tag

Speaker Rebekah Rittberg

Topic Small Cell Lung Cancer and Neuro-endocrine Tumours - RW/SOC

Keywords

immune checkpoint inhibitors

platinum-based chemotherapy

extensive stage small cell lung cancer

SCLC

CASPIAN

IMpower133

autoimmune conditions

ECOG performance status

real-world data

evidence gap