Feasibility of consolidative immunotherapy and outcomes of chemoradiation for limited-stage small-cell lung cancer in the real world
Shuo Shi, Teresa Romero Cruz, Florian Stritzke, Romina Maria Rösch, Marlene Luther-Lütkehus, Anna Hofmann, Benedikt Niedermaier, Michael Allgäuer, Farastuk Bozorgmehr, Rajiv Shah, Jonas Kuon, Thomas Held, Fabian Weykamp, Albrecht Stenzinger, Florian Eichhorn, Laura Klotz, Michael Thomas, Gerald Schmid-Bindert, Petros ChristopoulosBackground
Small-cell lung cancer (SCLC) is an aggressive disease presenting with limited stage (LS) in approximately 25% of cases.
Objectives
This study characterized the routine management of LS-SCLC as a benchmark for the advent of immune checkpoint inhibitors (ICI).
Design
A retrospective real-world cohort study of 533 consecutive patients with histologically confirmed LS-SCLC treated at the Thoraxklinik between 01/2010-12/2019.
Methods
Clinical characteristics were extracted from the patients’ records with reassessment of tumor response and progression according to RECIST v1.1 by the investigators.
Results
Of 533 patients, 418 (78.4%) received curative-intent treatment: definitive chemoradiation (CRT) in 392 patients (73.5%; sequential CRT in 303/392 [77.3%] and concurrent CRT in 89/392 [22.7%]), or surgery followed by adjuvant chemotherapy (n=16, 3.0%) or CRT (n=10, 1.9%). The remaining could receive only single-modality or no therapy with poor median overall survival (mOS) <6 months. Concurrent (
Conclusion
Definitive treatment was feasible for approximately 78% of LS-SCLC patients, while approximately 50% are estimated to be eligible for durvalumab post-CRT. Concurrent treatment and administration of PCI were independently associated with better outcomes, but the median OS <2 years in this real-world population underlines the urgent need for novel therapeutic options.