WCLC 2025 - Posters & ePosters-P1.11.29 ICIs Plus Paclitaxel-Based Chemotherapy Is an Optional Treatment for Transformed SCLC After EGFR-TKI

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This study from Peking University Cancer Hospital & Institute and National Cancer Center evaluates treatment options for EGFR-mutant non-small cell lung cancer (NSCLC) patients who develop small cell lung cancer (SCLC) transformation after resistance to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). The focus is on assessing immune checkpoint inhibitors (ICIs) combined with paclitaxel-based chemotherapy as a subsequent treatment after conventional etoposide/platinum regimens.<br /><br />The cohort included 46 patients divided into three groups: Group A (8 patients), who had SCLC transformation and received ICIs plus taxane-based chemotherapy; Group B (21 patients), with SCLC transformation but no ICIs treatment; and Group C (17 patients), without SCLC transformation but treated with taxane-based chemotherapy plus ICIs after EGFR-TKI.<br /><br />Key findings showed that in Group A, ICIs combined with albumin-bound paclitaxel resulted in a disease control rate (DCR) of 100% and objective response rate (ORR) of 12.5%, compared to a DCR of 76.2% and ORR of 14.3% in Group B receiving conventional chemotherapy (etoposide/platinum-based). Progression-free survival and overall survival analyses suggested improved outcomes with ICIs plus paclitaxel in transformed SCLC patients.<br /><br />Patient characteristics included a median age around 55, majority female and never smokers, with common EGFR mutations including 19DEL and L858R. Prior treatments varied, with some receiving first- and third-generation EGFR-TKIs, chemotherapy, and antiangiogenic therapies.<br /><br />The study concludes that for EGFR-mutant NSCLC patients undergoing SCLC transformation post EGFR-TKI resistance, an ICI plus albumin paclitaxel chemotherapy regimen represents an optimal subsequent therapy, providing better disease control compared to traditional etoposide/platinum treatment. No conflicts of interest were declared. This work highlights a promising treatment strategy to improve outcomes for this challenging patient population.

Asset Subtitle

Yuyan Wang

Meta Tag

Speaker Yuyan Wang

Topic Metastatic Non-small Cell Lung Cancer – Immunotherapy

Keywords

EGFR-mutant NSCLC

small cell lung cancer transformation

immune checkpoint inhibitors

paclitaxel-based chemotherapy

etoposide/platinum regimen

disease control rate

objective response rate

progression-free survival

overall survival

albumin-bound paclitaxel