WCLC 2025 - Posters & ePosters-EP.13.35 Sequential Atezolizumab Regimens (Chemo Followed by Anlotinib) for ES-SCLC: Real-World Data

Pdf Summary

This multicenter, prospective, real-world single-arm trial evaluated sequential treatment with atezolizumab plus chemotherapy followed by maintenance therapy with atezolizumab plus anlotinib in 69 patients with treatment-naïve extensive-stage small cell lung cancer (ES-SCLC). Patients received 4–6 induction cycles of atezolizumab combined with etoposide and carboplatin or cisplatin, followed by maintenance therapy with atezolizumab and anlotinib for up to two years. The primary endpoint was progression-free survival (PFS).<br /><br />Patient demographics showed a median age of 66 years, predominantly male (88.4%), mostly ECOG performance status 0–1, and the majority were smokers (85%). Seven patients (10%) had brain metastases at enrollment.<br /><br />At data cutoff (December 30, 2024), median PFS was 9 months (95% CI, 8–13 months). Tumor response rates included a 72.4% objective response rate (ORR) and a 95.6% disease control rate (DCR). Responses followed RECIST 1.1 criteria, with 1.4% complete responses, 71.0% partial responses, 23.2% stable disease, and 4.3% progressive disease.<br /><br />Safety analysis found 81% of patients experienced treatment-related adverse events (TRAEs), with 17.4% experiencing grade 3 to 5 events. Common TRAEs included neutropenia (43.4% grade 1-2; 11.6% grade 3-5), anemia, thrombocytopenia, nausea, pneumonia, myocarditis, and liver/kidney damage. Four fatal adverse events occurred (pneumonia [2], renal failure [1], myocarditis [1]).<br /><br />The study concluded that maintenance anlotinib combined with atezolizumab after chemo-immunotherapy shows a clinically meaningful PFS benefit with a favorable high-grade toxicity profile, likely helped by prophylactic recombinant human granulocyte colony-stimulating factor (rhG-CSF) use. This sequential approach may optimize efficacy while reducing toxicity compared to regimens combining anti-angiogenic therapy upfront in ES-SCLC.

Asset Subtitle

Xiaojun Qian

Meta Tag

Speaker Xiaojun Qian

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

atezolizumab

anlotinib

extensive-stage small cell lung cancer

ES-SCLC

progression-free survival

chemo-immunotherapy

maintenance therapy

treatment-related adverse events

objective response rate

real-world trial