Abstract
Background
Studies demonstrated that chemoimmunotherapy prolongs progression-free survival (PFS)
and overall survival (OS) in patients with extensive-stage small-cell lung cancer
(ES-SCLC) and an Eastern Cooperative Oncology Group performance status (ECOG-PS) of
0 or 1. However, there is little data regarding chemoimmunotherapy in patients with
ES-SCLC and an ECOG PS 2 or 3. This study aims to evaluate the benefits of chemoimmunotherapy
compared to chemotherapy in the first-line treatment of patients with ES-SCLC and
ECOG-PS 2 or 3.
Methods
This retrospective study analyzed 46 adults seen at Mayo Clinic between 2017-2020
with de novo ES-SCLC and an ECOG-PS 2 or 3. Twenty patients received platinum-etoposide
and 26 patients received platinum-etoposide and atezolizumab. Overall survival (OS)
and progression-free survival (PFS) were calculated using Kaplan-Meier methods.
Results
There was no statistically significant difference in the overall survival between
the chemoimmunotherapy and chemotherapy group (9.3 months [95% confidence interval:
4.9-12.8] vs 7.6 months [0.6-11.9], respectively; p = 0.21). PFS was longer in the
chemoimmunotherapy group compared to the chemotherapy group (4.1 months [3.8-6.9]
vs 3.2 months [0.6-4.8], respectively; p = 0.0491).
Conclusion
Patients with ES-SCLC and an ECOG of 2 or 3 who received chemoimmunotherapy had a
longer PFS compared to patients who received chemotherapy. While there was no difference
in OS between the two treatment groups, this may be due to the small study size and
thus lack of power of the study. Further research with a larger study size is needed
to evaluate the potential benefit of chemoimmunotherapy on the OS.
MicroAbstract
Prior studies have demonstrated that chemoimmunotherapy, compared to chemotherapy,
prolongs PFS and OS in patients with ES-SCLS and an ECOG-PS of 0 or 1 but have excluded
patients with an ECOG-PS of 2-3. This study shows that chemoimmunotherapy prolongs
PFS in patients with ES-SCLC and an ECOG of 2 or 3, and so clinicians should consider
chemoimmunotherapy for these patients.
Keywords
Abbreviations:
extensive-stage small-cell lung cancer ((ES-SCLC)), progression-free survival ((PFS)), overall survival ((OS)), Eastern Cooperative Oncology Group performance status ((ECOG-PS)), etoposide and platinum-based therapy ((EP)), programmed death-ligand 1 ((PD-L1) and its receptor), programmed cell death protein 1 ((PD-1)), standard deviations ((SD))To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
May 22,
2023
Received in revised form:
May 21,
2023
Received:
May 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Published by Elsevier Inc.
