2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.13D.04 The Conflicting Impacts of G-CSF on the Therapeutic Efficacy of Chemoimmunotherapy for Extensive Stage Small Cell Lung Cancer

EP.13D.04 The Conflicting Impacts of G-CSF on the Therapeutic Efficacy of Chemoimmunotherapy for Extensive Stage Small Cell Lung Cancer

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The study investigates the impact of granulocyte colony-stimulating factor (G-CSF) on the efficacy of chemo-immunotherapy in treating extensive-stage small cell lung cancer (ES-SCLC). G-CSF is commonly used to counteract chemotherapy-induced neutropenia, but it may also promote tumor growth by suppressing the anti-tumor immune response through immune suppressive cells. The retrospective study, conducted across multiple hospitals, included 65 patients with ES-SCLC, treated with chemo-immunotherapy, consisting of atezolizumab or durvalumab combined with carboplatin and etoposide, between January 2019 and July 2022.<br /><br />The study compared progression-free survival (PFS) and overall survival (OS) in patients who received G-CSF to those who did not. Results showed that patients receiving G-CSF had significantly poorer PFS compared to those who did not, although there was no significant difference in OS between the groups. Multivariate analysis identified G-CSF as an independent poor prognostic factor for PFS. <br /><br />The study suggests that while G-CSF may help prevent infections and maintain chemotherapy dose intensity, it could negatively impact immune checkpoint inhibitor (ICI) efficacy by increasing myeloid-derived suppressor cell levels, thus impairing anti-tumor immunity. The findings underscore the importance of cautious use of G-CSF in patients undergoing chemo-immunotherapy for ES-SCLC, noting limitations including a small sample size, short follow-up period, and absence of immunological analyses.<br /><br />Overall, the study suggests that while G-CSF can have benefits, its role in immunotherapy must be carefully considered due to its potential to reduce the treatment’s effectiveness. Further research is needed to fully understand and optimize G-CSF use in cancer treatment strategies.

Asset Subtitle

Yuki Tsukazaki

Meta Tag

Speaker Yuki Tsukazaki

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

granulocyte colony-stimulating factor

G-CSF

chemo-immunotherapy

extensive-stage small cell lung cancer

ES-SCLC

progression-free survival

overall survival

immune checkpoint inhibitor

myeloid-derived suppressor cells

anti-tumor immunity