2023 World Conference on Lung Cancer (Posters)-EP13.03. Real-World Analysis of ICI Efficacy in ES-SCLC Patients with and without Brain Metastases: A Call for Inclusion in Clinical Trials

EP13.03. Real-World Analysis of ICI Efficacy in ES-SCLC Patients with and without Brain Metastases: A Call for Inclusion in Clinical Trials - PDF(Abstract)

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This study analyzed the real-world efficacy of immune checkpoint inhibitors (ICIs) in patients with extensive stage small-cell lung cancer (ES-SCLC) with and without brain metastases (BM). ICIs, such as atezolizumab, have shown success in treating ES-SCLC in combination with chemotherapy. However, patients with BM are often excluded from clinical trials due to their perceived poor prognosis. The aim of this study was to evaluate the effectiveness of ICIs in achieving disease response and managing intracranial disease in ES-SCLC patients.<br /><br />The researchers conducted a retrospective study on patients with biopsy-confirmed ES-SCLC who were treated with atezolizumab/carboplatin/etoposide combination from 2015 to 2022. They examined overall survival, progression-free survival, and radiographic response in patients with and without BM. They also documented intracranial response in patients with BM who had follow-up brain imaging after starting ICI.<br /><br />Of the 83 patients included in the study, 39.3% had BM. Disease progression occurred in 90.9% of patients with BM and death in 51.5%. Among the patients who underwent intracranial response assessment, 4.8% had complete response, 19.0% had partial response, 9.5% had stable disease, and 66.7% had disease progression. The median duration of intracranial response was 5.3 months, and the objective response rate was 23.8%. There was no significant difference in overall survival or progression-free survival between patients with and without BM. However, patients with more than 3 BM had inferior survival outcomes.<br /><br />The study concluded that ICIs achieved similar outcomes in ES-SCLC patients with and without BM and produced meaningful intracranial responses in patients with BM. Therefore, future clinical trials on ES-SCLC should include patients with BM, especially those with more than 3 BM. Further research on a larger and more diverse patient population is recommended.

Asset Subtitle

Yuanzhen Cao

Meta Tag

Speaker Yuanzhen Cao

Topic SCLC & Neuroendocrine Tumors: First Line Therapy

Keywords

immune checkpoint inhibitors

extensive stage small-cell lung cancer

brain metastases

atezolizumab

chemotherapy

clinical trials

overall survival

progression-free survival

radiographic response

intracranial response