Long-term effectiveness and treatment sequences in patients with extensive stage small cell lung cancer receiving atezolizumab plus chemotherapy: Results of the IFCT-1905 CLINATEZO real-world study.

Chemotherapy Immunotherapy Small cell lung cancer Targeted therapy

Journal

Lung cancer (Amsterdam, Netherlands)
ISSN: 1872-8332
Titre abrégé: Lung Cancer
Pays: Ireland
ID NLM: 8800805

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 23 05 2023
revised: 13 09 2023
accepted: 14 09 2023
pubmed: 28 9 2023
medline: 28 9 2023
entrez: 27 9 2023
Statut: ppublish

Résumé

Small cell lung cancer (SCLC) has a tendency towards recurrence and limited survival. Standard-of-care in 1st-line is platinum-etoposide chemotherapy plus atezolizumab or durvalumab,based on landmarkclinical trials. IFCT-1905 CLINATEZO is a nationwide, non-interventional, retrospectivestudy of patients with extensive-SCLC receivingatezolizumab plus chemotherapy as part of French Early Access Program. Objectives were to analyse effectiveness,safetyand subsequent treatments. The population analyzed included 518 patients who received atezolizumabin 65 participating centers. There were 66.2% male,mean age was 65.7 years; 89.1% had a performance status (PS) 0/1 and 26.6% brain metastases. Almost all(95.9%) were smokers. Fifty-five (10.6%) received at least 1 previous treatment. Median number of atezolizumab injections was 7.0 (range [1.0-48.0]) for a median duration of 4.9 months (95% CI 4.5-5.1). Atezolizumab was continued beyond progression in 122 patients (23.6%) for a median duration of 1.9 months (95% CI: [1.4-2.3]). Best objective response was complete and partialin 19 (3.9%) and 378 (77.1%)patients. Stable diseasewas observed in 50 patients (10.2%). Median follow-up was30.8 months (95% CI: [29.9-31.5]). Median overall survival (OS), 12-, 24-month OS rates were 11.3 months (95% CI: [10.1-12.4]), 46.7% (95% CI [42.3-50.9]) and 21.2% (95% CI [17.7-24.8]). Median real-world progression-free survival, 6-, 12-month rates were 5.2 months (95% CI [5.0-5.4]), 37.5% (95% CI [33.3-41.7]) and 15.2% (95% CI [12.2-18.6]). For patients with PS 0/1, median OS was 12.2 months (95% CI [11.0-13.5]). For patients with previous treatment, median OS was 14.9 months (95% CI [10.1-21.5]). Three-hundred-and-twenty-six patients(66.4%) received subsequent treatment and27 (5.2%) were still underatezolizumabat date of last news. IFCT-1905 CLINATEZO shows reproductibility, in real-life,ofIMpower-133survival outcomes, possibly attributed to selection of patients fit for this regimen, adoption of pragmatic approaches,including concurrent radiotherapy and treatment beyond progression.

Sections du résumé

BACKGROUND BACKGROUND
Small cell lung cancer (SCLC) has a tendency towards recurrence and limited survival. Standard-of-care in 1st-line is platinum-etoposide chemotherapy plus atezolizumab or durvalumab,based on landmarkclinical trials.
METHODS METHODS
IFCT-1905 CLINATEZO is a nationwide, non-interventional, retrospectivestudy of patients with extensive-SCLC receivingatezolizumab plus chemotherapy as part of French Early Access Program. Objectives were to analyse effectiveness,safetyand subsequent treatments.
RESULTS RESULTS
The population analyzed included 518 patients who received atezolizumabin 65 participating centers. There were 66.2% male,mean age was 65.7 years; 89.1% had a performance status (PS) 0/1 and 26.6% brain metastases. Almost all(95.9%) were smokers. Fifty-five (10.6%) received at least 1 previous treatment. Median number of atezolizumab injections was 7.0 (range [1.0-48.0]) for a median duration of 4.9 months (95% CI 4.5-5.1). Atezolizumab was continued beyond progression in 122 patients (23.6%) for a median duration of 1.9 months (95% CI: [1.4-2.3]). Best objective response was complete and partialin 19 (3.9%) and 378 (77.1%)patients. Stable diseasewas observed in 50 patients (10.2%). Median follow-up was30.8 months (95% CI: [29.9-31.5]). Median overall survival (OS), 12-, 24-month OS rates were 11.3 months (95% CI: [10.1-12.4]), 46.7% (95% CI [42.3-50.9]) and 21.2% (95% CI [17.7-24.8]). Median real-world progression-free survival, 6-, 12-month rates were 5.2 months (95% CI [5.0-5.4]), 37.5% (95% CI [33.3-41.7]) and 15.2% (95% CI [12.2-18.6]). For patients with PS 0/1, median OS was 12.2 months (95% CI [11.0-13.5]). For patients with previous treatment, median OS was 14.9 months (95% CI [10.1-21.5]). Three-hundred-and-twenty-six patients(66.4%) received subsequent treatment and27 (5.2%) were still underatezolizumabat date of last news.
CONCLUSIONS CONCLUSIONS
IFCT-1905 CLINATEZO shows reproductibility, in real-life,ofIMpower-133survival outcomes, possibly attributed to selection of patients fit for this regimen, adoption of pragmatic approaches,including concurrent radiotherapy and treatment beyond progression.

Identifiants

pubmed: 37757576
pii: S0169-5002(23)00917-0
doi: 10.1016/j.lungcan.2023.107379
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107379

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Lionel Falchero (L)

Service de Pneumologie et Cancérologie Thoracique, Hôpitaux Nord-Ouest, Villefranche Sur Saône, France.

Florian Guisier (F)

Univ Rouen Normandie, LITIS Lab QuantIF team EA4108, Rouen, France, CHU Rouen, Inserm CIC-CRB 1404, Department of Pneumology, Thoracic oncology and respiratory intensive care, Rouen, France.

Marie Darrason (M)

HCL, Centre Hospitalier Lyon Sud, URCC Secteur essais cliniques, Pierre-Bérard, France.

Arnaud Boyer (A)

Hôpital Saint Joseph, Service de Pneumologie, Marseille, Franc'.

Charles Dayen (C)

Clinique de l'Europe, Service de Pneumologie, Amiens, France.

Sophie Cousin (S)

Institut'Bergonié, Département d'Oncologie Médicale, Bordeaux, France.

Patrick Merle (P)

CHU, Hôpital Gabriel Montpied, Hôpital de jour, Service d'oncologie Thoracique, Clermont Ferrand, France.

Régine Lamy (R)

CHBS, Hôpital Du Scorff, Oncologie médicale, Lorient, France.

Anne Madroszyk (A)

Institut Paoli Calmettes, Département d'Oncologie Médicale, Marseille, France Centre Antoine Lacassagne, Oncologie, Nice, France.

Josiane Otto (J)

Centre Antoine Lacassagne, Nice, France.

Pascale Tomasini (P)

APHM, Service d'Oncologie Multidisciplinaire &Franceations Thérapeutiques, Hôpital Nord, Marseille, France.

Sandra Assoun (S)

APHP, Service de Pneumologie, Hôpital Bichat, Paris, France.

Anthony Canellas (A)

APHP, Service de Pneumologie, Hôpital Tenon, Paris, France.

Radj Gervais (R)

Service de Pneumol'gie, Centre François Baclesse, Caen, France.

José Hureaux (J)

Service de Pneumologie, CHU Angers, Angers, France.

Jacques Le Treut (J)

Service de Pneumologie, Hôpital Européen, Marseille, France.

Olivier Leleu (O)

Service de Pneumologie, Centre Hospitalier, Abbeville, France.

Charles Naltet (C)

Service de Pneumologie Oncologie, Groupe Hospitalier ParisFrance Joseph, Paris, France.

Marie Tiercin (M)

Fédération de Pneumologie, Centre Hospitalier, Saint Malo, France.

Sylvie Van Hulst (S)

Service de Cancérologie, Centre Hospitalier Universitaire, Nîmes, France.

Pascale Missy (P)

IFCT, Unité de Recherche Clinique, Paris, France.

Franck Morin (F)

IFCT, Unité de Recherche Clinique, Paris, France.

Virginie Westeel (V)

CHU Besançon, Hôpita Minjoz, Service de Pneumologie, Besançon, France.

Nicolas Girard (N)

Institut du Thorax Curie Montsouris, Institut Curie, Paris, France, Paris Saclay University, University Versailles Saint Quentin, Versailles, France. Electronic address: nicolas.girard2@curie.fr.

Classifications MeSH