5PSQ-002 Atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer

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Background and Importance Atezolizumab in combination with carboplatin-etoposide is indicated for the first-line treatment of extensive-stage small-cell lung cancer (ES-SCLC). Different studies have demonstrated promising efficacy and safety with atezolizumab plus chemotherapy. Real-life studies are commonly performed to confirm the results. Aim and Objectives The aim of our study is to analyse the effectiveness and safety of atezolizumab combined with chemotherapy in ES-SCLC in a tertiary hospital, and to compare with the pivotal IMpower133 trial. Material and Methods Retrospective observational study was conducted. We included patients treated with atezolizumab plus chemotherapy from January 2022 to July 2024. Variables collected: sex, age, smoking status, quality of life status according to the Eastern Cooperative Oncology Group (ECOG) scale, location of metastases, comorbidities, duration of treatment, objective response rate (ORR) according to RECIST-v1.1 criteria (Response Evaluation Criteria in Solid Tumours), progression-free survival (PFS) and overall survival (OS) calculated by Kaplan-Meier method, cause of treatment discontinuation and adverse events (AEs) according to Common Terminology Criteria for Adverse Events v.5 (CTCAE). Data obtained from the electronic medical record (Diraya) and software Farmis_Oncofarmand processed with SPSS Statistics v.21. Results Thirty patients (83% male) were included; median age of 62 years (Interquartile range (IQR):58–68); 80% smokers (20% ex-smokers). 70% had an ECOG:1 at baseline (17% ECOG≥2; 13% ECOG:0). The most frequent locations of metastases were: hepatic (40%), bone (40%), renal (37%) and lung (20%). The most frequent comorbidities were: arterial hypertension (50%), dyslipidaemia (26.7%) and diabetes mellitus II (13.3%). Median duration of treatment was 5.5 months (IQR:3.5–7.8). At the date of analysis (06 August 2024), eight patients are still on treatment. ORR was partial in 63% of patients (7% not evaluated). Median PFS and OS were 6.7 (95% CI 5.8–13.07) and 10.4 (95% CI 9.74–17.82) months, respectively. 68.2% of patients discontinued treatment due to disease progression, 18.2% exitus and 13.6% AEs. 87% of patients had some AE during treatment. Most frequent AEs were: neutropenia 73% (G3–4:38.5–7.7%), anaemia 61.5% (G3:34.6%), asthenia 57.7% (G3:3.8%), thrombocytopenia 38.5% (G3:15.4%), elevated transaminases 23% (G3:3.8%), nausea 19.2% (G3:0%), and diarrhoea 11.5% (G3:0%). Three patients discontinued treatment due to AEs. Conclusion and Relevance Median OS was lower than that observed in the pivotal IMpower133 trial, while PFS was higher. Although the majority of patients presented some AE, in three patients were these AEs forced to discontinue treatment. Further studies with a larger sample size and longer follow-up period are needed to confirm these real-life results. References and/or Acknowledgements Conflict of Interest No conflict of interest

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