WCLC 2025 - Posters & ePosters-P3.13.15 First-Line Immunochemotherapy in ES-SCLC Patients With ECOG PS =2: Real-World Evidence From the ASTRUM-005R Trial

P3.13.15 First-Line Immunochemotherapy in ES-SCLC Patients With ECOG PS =2: Real-World Evidence From the ASTRUM-005R Trial

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This subgroup analysis from the real-world ASTRUM-005R study evaluates the effectiveness of first-line serplulimab-based immunochemotherapy in extensive-stage small cell lung cancer (ES-SCLC) patients with poor performance status, specifically those with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2. Traditionally, such patients are underrepresented in clinical trials, making real-world evidence crucial.<br /><br />The analysis included 75 patients with ECOG PS 2, comprising 11.8% of the total ASTRUM-005R cohort. The median age was 67 years, with most patients (98.67%) at clinical stage IV. Brain metastases were present in 34.67%, and liver metastases in 44% of patients. The median follow-up was 16.37 months.<br /><br />Key efficacy outcomes showed an overall response rate (ORR) of 66.22% among 74 evaluable patients. Real-world progression-free survival (rwPFS) median was 6.97 months, with a 1-year rwPFS rate of 26.62%. Patients with liver metastases had significantly shorter rwPFS (4.93 vs. 10.30 months) and overall survival (OS) (9.67 vs. 14.03 months). Brain metastases did not significantly impact rwPFS or OS. The median OS for patients with PS 2 was 12.33 months, though OS was poorer compared to patients with better performance status.<br /><br />Safety analysis revealed that 26.67% experienced adverse events, with immune-related adverse events (irAEs) in 20% and 5 patients experiencing grade 3 irAEs.<br /><br />In conclusion, first-line serplulimab-based immunochemotherapy is feasible and clinically effective in ES-SCLC patients with ECOG PS 2, supporting its use even in populations traditionally excluded from clinical trials. Liver metastasis, but not brain metastasis, correlated with worse outcomes, highlighting a need for tailored management strategies. These findings warrant further prospective validation.

Asset Subtitle

Lin Wu

Meta Tag

Speaker Lin Wu

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

serplulimab

immunochemotherapy

extensive-stage small cell lung cancer

ES-SCLC

ECOG performance status 2

real-world evidence

liver metastases

brain metastases

overall response rate

progression-free survival