1531P Primary results from IMfirst, a phase IIIb open label safety study of atezolizumab (ATZ) + carboplatin (CB)/cisplatin (CP) + etoposide (ET) in an interventional real-world (RW) clinical setting of extensive-stage small cell lung cancer (ES-SCLC) in Spain

Campelo, M.R. García; Gómez, M. Dómine; Carpeno, J. De Castro; Vega, Antonio López; Aix, S. Ponce; Arriola, E.; Costa, E. Carcereny; Tarruella, M. Majem; Vence, Gerardo Huidobro; González, Emilio Esteban; Pradera, J. Fuentes; Granados, A.L. Ortega; Morales, M. Guillot; Sureda, B. Massutí; Martinez, L. Vila; Cordellat, A. Blasco; Fajardo, C.A.; Crama, L.; Laborda, N. Lerones; Dols, M. Cobo

doi:10.1016/j.annonc.2022.07.1626

Cited by 7 publications

(3 citation statements)

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“…Recently, several retrospective studies and phase IIIb trials were conducted in different countries to evaluate the safety of the new standard in a real-world setting, allowing the inclusion of patients with poor Eastern Cooperative Oncology Group performance status (ECOG-PS 2) and the extension of the induction phase up to six cycles of chemotherapy in the experimental arm [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. These studies demonstrated non-addictive toxicity by prolonging the induction phase up to six cycles; however, the number of patients with ECOG-PS 2 was too low to identify the benefit and tolerability of the ICI plus CT combination in this subgroup population ( Supplementary Data, Table S1 ).…”

Section: Current Treatment Optionsmentioning

confidence: 99%

The Evolving Scenario of ES-SCLC Management: From Biology to New Cancer Therapeutics

Trillo Aliaga,

Del Signore,

Fuorivia

et al. 2024

Genes

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Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma accounting for 15% of lung cancers with dismal survival outcomes. Minimal changes in therapy and prognosis have occurred in SCLC for the past four decades. Recent progress in the treatment of extensive-stage disease (ES-SCLC) has been marked by incorporating immune checkpoint inhibitors (ICIs) into platinum-based chemotherapy, leading to modest improvements. Moreover, few second-line-and-beyond treatment options are currently available. The main limitation for the molecular study of SCLC has been the scarcity of samples, because only very early diseases are treated with surgery and biopsies are not performed when the disease progresses. Despite all these difficulties, in recent years we have come to understand that SCLC is not a homogeneous disease. At the molecular level, in addition to the universal loss of retinoblastoma (RB) and TP53 genes, a recent large molecular study has identified other mutations that could serve as targets for therapy development or patient selection. In recent years, there has also been the identification of new genetic subtypes which have shown us how intertumor heterogeneity exists. Moreover, SCLC can also develop intratumoral heterogeneity linked mainly to the concept of cellular plasticity, mostly due to the development of resistance to therapies. The aim of this review is to quickly present the current standard of care of ES-SCLC, to focus on the molecular landscapes and subtypes of SCLC, subsequently present the most promising therapeutic strategies under investigation, and finally recap the future directions of ongoing clinical trials for this aggressive disease which still remains a challenge.

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Section: Current Treatment Optionsmentioning

confidence: 99%

The Evolving Scenario of ES-SCLC Management: From Biology to New Cancer Therapeutics

Trillo Aliaga,

Del Signore,

Fuorivia

et al. 2024

Genes

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“…Whether immunotherapy plus chemotherapy is suitable for ES-SCLC in the real world also needs to be evaluated. A prospective real-world study of first-line immunotherapy for ES-SCLC from Spain included 155 patients (the Imfirst study) (13). There were 11.0% of patients with Eastern Cooperative Oncology Group performance status (ECOG) ≥2 and 17.4% of patients with brain metastases.…”

Section: New Evidence Of First-line Immunotherapy For Es-sclcmentioning

confidence: 99%

“…First-line treatment with durvalumab plus platinumetoposide (EP) significantly improved the OS (HR, 0.73; 95% CI, 0.59-0.91) of patients with ES-SCLC. The median OS of patients in the durvalumab plus chemotherapy group and chemotherapy group was 13.0 and 10.3 months, respectively. However, there was no significant difference in PFS between these two groups (6).…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy for extensive-stage small-cell lung cancer: current landscape and future perspectives

Zhang

Cheng

2023

Front. Oncol.

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Small-cell lung cancer (SCLC) is a fatal subtype of lung cancer characterized by high aggressiveness, poor prognosis, and limited treatment options. For the first time in more than three decades, it has been demonstrated that the addition of immunotherapy to chemotherapy improved the survival of patients with extensive-stage SCLC, thereby immunotherapy plus chemotherapy established a new standard of first-line treatment. However, it is important to improve the curative effect of immunotherapy on SCLC and identify the patients who could benefit from such treatment. In this article, we review the current status of the first-line immunotherapy, the strategies to improve the efficacy of immunotherapy and the discovery of potential predictive biomarkers of immunotherapy for SCLC.

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Role of consolidative thoracic radiation in extensive-stage small-cell lung cancer with first-line chemoimmunotherapy: a retrospective study from a single cancer center

Wang

Jing

et al. 2023

Discov Onc

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Objective To investigate the role of consolidative thoracic radiation (TRT) in extensive-stage small-cell lung cancer (ES-SCLC) receiving first-line chemo-immunotherapy followed by immunotherapy maintenance. Patients and methods Outcomes of patients without disease progression after first-line chemotherapy were retrospectively reviewed (January 2020 to December 2021). Based on TRT or not, patients were allocated to TRT group or non-TRT group. Progression-free survival (PFS), overall survival (OS) and local-recurrence free survival (LRFS) were calculated by the Kaplan–Meier method and compared by log-rank test. Results Of 100 patients, 47 received TRT and 53 non-TRT. The median follow-up was 20.3 months. The median PFS and OS in TRT were 9.1 months and 21.8 months, versus 8.8 months (p = 0.93) and 24.3 months (p = 0.63), respectively, in non-TRT. The median LRFS time in TRT was not reached, but significantly longer than 10.8 months in non-TRT (HR = 0.27, p < 0.01). Second-line chemotherapy significantly prolonged survival compared to that with chemo-free patients (mOS: 24.5 vs. 21.4 months, p = 0.026). The subgroup analysis showed a trend of patients with brain metastases benefit from TRT (21.8 versus 13.7 months, HR 0.61, p = 0.38) while liver metastases did not. Of 47 patients with TRT, only 10.6% of patients experienced grade 3 radiation-induced pneumonitis, while no grade 4 or 5 adverse events occurred. Conclusion Consolidative TRT in the period of immunotherapy maintenance followed first-line chemo-immunotherapy did not prolong OS and PFS but associated with improved LRFS in ES-SCLC.

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1531P Primary results from IMfirst, a phase IIIb open label safety study of atezolizumab (ATZ) + carboplatin (CB)/cisplatin (CP) + etoposide (ET) in an interventional real-world (RW) clinical setting of extensive-stage small cell lung cancer (ES-SCLC) in Spain

Cited by 7 publications

References 0 publications

The Evolving Scenario of ES-SCLC Management: From Biology to New Cancer Therapeutics

The Evolving Scenario of ES-SCLC Management: From Biology to New Cancer Therapeutics

Immunotherapy for extensive-stage small-cell lung cancer: current landscape and future perspectives

Role of consolidative thoracic radiation in extensive-stage small-cell lung cancer with first-line chemoimmunotherapy: a retrospective study from a single cancer center

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