2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.13B.12 Chemotherapy Sensitivity for Recurrent Small-Cell Lung Cancer Based on Chemotherapy-Free Interval and Treatment Regimens

EP.13B.12 Chemotherapy Sensitivity for Recurrent Small-Cell Lung Cancer Based on Chemotherapy-Free Interval and Treatment Regimens

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The study by Yuki Akazawa and colleagues from the NHO Osaka Toneyama Medical Center investigates chemotherapy sensitivity in recurrent small-cell lung cancer (SCLC) based on chemotherapy-free intervals (CTFI) and treatment regimens. SCLC, a highly aggressive form of lung cancer, often recurs after initial treatment despite its high response rate. The researchers analyzed 212 cases treated between January 2014 and July 2024 to assess the outcomes based on treatment timing and types.<br /><br />Current guidelines define "sensitive relapse" as recurrence after various chemotherapy-free intervals, with ESMO and Japan’s guidelines setting the threshold at 90 days and the NCCN guidelines at 180 days. The study's analysis showed that CTFI is consequential in determining the response to second-line treatments. Patients in the CTFI180 group showed more favorable responses to platinum-doublet rechallenge and monotherapy (55% and 56%, respectively) than those with shorter intervals.<br /><br />Most patients whose disease recurred within 90 days (CTFI90) showed low response rates to a second round of platinum-based chemotherapy, highlighting the need for alternative treatments due to limited effectiveness. This highlights a demand for drugs with different mechanisms, such as antibody-drug conjugates targeting specific proteins like delta-like ligand 3.<br /><br />Moreover, previous administration of immune checkpoint inhibitors (ICIs) did not significantly enhance the response rates for second-line chemotherapy in recurrent SCLC, in stark contrast to similar treatments used for non-small cell lung cancer (NSCLC), noting limited evidence to support synergy with prior ICI treatments.<br /><br />The study concludes that despite advancements in drugs like amrubicin and lurbinectedin, the development of new treatments beyond conventional cytotoxic options remains crucial, especially for patients with shorter CTFIs, who often exhibit resistance to existing therapies. This research underscores the necessity for novel therapeutic options to improve outcomes for patients with recurrent SCLC.

Asset Subtitle

Yuki Akazawa

Meta Tag

Speaker Yuki Akazawa

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

small-cell lung cancer

chemotherapy sensitivity

chemotherapy-free intervals

recurrence

platinum-doublet rechallenge

antibody-drug conjugates

immune checkpoint inhibitors

amrubicin

lurbinectedin

novel therapeutic options