2002P A multicentre study assessing the real-world effectiveness of first-line chemotherapy plus immunotherapy in extensive-stage small cell lung cancer (ES-SCLC) patients

First-line chemotherapy plus immunotherapy (CT-IO) has recently demonstrated survival benefit over CT in Extensive-Stage Small Cell Lung Cancer (ES-SCLC) patients, based on randomized phase 3. This retrospective multicentre study assessed the real-world effectiveness of CT-IO since its approval in France in May 2020, in unselected patients. Data from all ES-SCLC patients treated with CT-IO at four French hospitals between May 2020 and December 2021 were retrospectively analyzed. Kaplan Meier method was used to estimate OS and real-world progression-free survival (rwPFS), and Cox regression analysis to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) in univariate and multivariate models. Of 75 patients included, median age was 69 years [IQR: 60.5-72.5], performans status (PS) was 0-1 in 78.7% of patients. Brain and liver metastases were present at baseline in 26.8% and 54.7% of patients respectively, and 28% of patients had corticosteroids ≥ 10 mg/day. At a median follow up of 16.8 months (95%CI: 14.9-23.4), the median OS was 11.4 months (95%CI: 7.7-14.7) with a 12-months OS rate of 43.6% (95%CI: 33.3-57.2). The median rwPFS was 5.3 months (95%CI: 4.8-5.8), 6-months PFS rate was 33.3% (95%CI: 24.2-45.9) and the objective response rate (ORR) was 76.7%. Introduction of delayed IO at the second cycle was not associated with a worse OS (HR 1.62, 95%CI: 0.88-2.97, p=0.132). In multivariate analyses, baseline brain and liver metastases were associated with a shorter OS (HR 3.80 [95%CI: 1.90-7.60] and 3.12 [95%CI: 1.60-6.08] respectively, p<0.001 for both). Our study showed that survival data in real-world ES-SCLC patients treated with frontline CT-IO were promising and comparable to those obtained from randomized trials, even amongst an unselected population including older patients, with untreated brain metastases or corticosteroids.