OVERALL SURVIVAL IN ES-SCLC HAS SEEN LIMITED IMPROVEMENT FOR SOME PATIENTS OVER THE LAST 30 YEARS1
SCLC IS THE MOST AGGRESSIVE SUBTYPE OF LUNG CANCER WITH EXTREMELY POOR PROGNOSIS1,3
SCLC accounts for ~15% of all
2 out of 3 patients with SCLC have ES‑SCLC at time of diagnosis2
5-year survival rate for distant SCLC is only 3.6%3
CURRENT SOC TREATMENT STRATEGIES FOR ES-SCLC1
- Early first-line regimens using platinum-based agents plus etoposide (EP) provided an mOS of approximately 10 months
- Since then, the introduction of PD-L1 inhibitors combined with chemotherapy in ex-US studies showed improvement of 2 months longer mOS versus chemotherapy alone
- OS improved by 2 months over chemotherapy
- Safety for PD-L1 inhibitors combined with chemotherapy were consistent with the safety profile of the individual medicines with no new safety signals identified
SEE mOS WITH PD-L1 + CHEMOTHERAPY
IMPOWER133 TRIAL DESIGN4,5
- Multinational, phase 3, double-blind, randomized, placebo-controlled trial
- In the induction phase, 403 patients were assigned in a 1:1 ratio to receive four 21-day cycles of carboplatin and etoposide administered with either atezolizumab or placebo; 201 received atezolizumab and 202 received placebo
- Induction phase was followed by maintenance phase during which patients received either atezolizumab or placebo per prior randomization until the toxic effects became unacceptable or disease progression according to RECIST, version 1.1
ATEZOLIZUMAB + CHEMOTHERAPY — THE CURRENT SOC FOR ES-SCLC PROVIDES MODEST SURVIVAL IMPROVEMENT4,5
- Atezolizumab + carboplatin/etoposide for untreated ES-SCLC improved mOS by 2 months compared to chemotherapy alone (12.3 months versus 10.3 months; (HR, 0.70 [95% Cl, 0.54-0.91; P=0.007]))5
Overall survival
ATEZOLIZUMAB + CHEMOTHERAPY DEMONSTRATED A SAFETY PROFILE CONSISTENT WITH DEFINED TOXICITY OF INDIVIDUAL AGENTS5
- The most common grade 3 or 4 AEs were neutropenia, anemia, and decreased neutrophil count
- Treatment-related AEs occurred in 94.9% of patients in the atezolizumab group compared with 92.3% in the placebo group
- Immune-related AEs occurred in 39.9% of patients in the atezolizumab group and in 24.5% of patients in the placebo group
AEs related to trial regimen5*
*The date of data cutoff was April 24, 2018. Multiple occurrences of the same adverse event in one patient were counted once at the highest grade for the preferred term. The incidence of treatment-related adverse events associated with any component of the trial regimen is shown.
AEs=adverse events; CI=confidence interval; HR=hazard ratio; mOS=median overall survival; PD-L1=programmed cell death ligand 1; RECIST=Response Evaluation Criteria in Solid Tumors; SOC=standard of care.
References: 1. Cheng Y, Han L, Wu L, et al. Effect of first-line serplulimab vs placebo added to chemotherapy on survival in patients with extensive-stage small cell lung cancer: the ASTRUM-005 randomized clinical trial. JAMA. 2022;328(12):1223-1232. 2. Rudin CM, Brambilla E, Faivre-Finn C, Sage J. Small-cell lung cancer. Nat Rev Dis Primers. 2021;7(1):1-43. 3. SEER*Explorer Surveillance Research Program, National Cancer Institute; 2023. Updated November 16, 2023. Accessed March 22, 2024. https://seer.cancer.gov.statistics-network/explorer 4. TECENTRIQ Prescribing Information. Genentech, Inc. 5. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med. 2018;379:2220-2229.
