WCLC 2025 - Posters & ePosters-EP.13.16 Safety and Efficacy of Chemoimmunotherapy in Stage IV Small Cell Lung Cancer: A Single-Center Retrospective Analysis

EP.13.16 Safety and Efficacy of Chemoimmunotherapy in Stage IV Small Cell Lung Cancer: A Single-Center Retrospective Analysis

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This retrospective single-center study at University Hospitals KU Leuven assessed the real-world safety and efficacy of first-line chemoimmunotherapy (Carboplatin, Etoposide, and Atezolizumab per IMpower133 protocol) in 74 patients with stage IV small cell lung cancer (SCLC) treated between 2018 and 2022. Patients had a median age of 66 years, were predominantly male (70%), and exhibited relatively high rates of brain (74%), bone (65%), and liver (54%) metastases, indicating a frailer population compared to pivotal IMpower133 and other cohorts.<br /><br />Outcomes showed a median progression-free survival (PFS) of 4.8 months and median overall survival (OS) of 11.5 months, closely aligned with results from the IMpower133 trial and comparable real-world datasets from Switzerland/UK. The objective response rate was high at 80%, and disease control rate 89%. Five-year survival was 8.9%. Median follow-up duration was 44.3 months. Treatment-related adverse events (TRAE) were frequent (89%), with 74% grade 3 severity and 4% grade 5 (all neutropenic septic shock). Immune-related adverse events occurred in 28% but no treatment-related deaths from immunotherapy were observed.<br /><br />Multivariate analysis identified clinical factors prognostic for worse survival: older age, presence of bone metastases, elevated neuron-specific enolase (NSE ≥ 250 µg/l), and low serum albumin (<35 g/l). Notably, systemic inflammation scores such as neutrophil-lymphocyte ratio and Glasgow prognostic score did not predict outcomes in this cohort.<br /><br />In conclusion, real-world chemoimmunotherapy for extensive stage SCLC demonstrated long-term efficacy and safety comparable to clinical trial data despite a frailer patient population with more advanced metastatic disease. Conventional clinical and biochemical markers effectively predicted overall survival, whereas systemic inflammation markers did not. These findings validate the use of chemoimmunotherapy in routine practice and highlight prognostic factors to guide clinical decision-making.

Asset Subtitle

Arne Peeters

Meta Tag

Speaker Arne Peeters

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

small cell lung cancer

chemoimmunotherapy

Carboplatin

Etoposide

Atezolizumab

IMpower133

progression-free survival

overall survival

treatment-related adverse events

prognostic factors