Efficacy and safety of atezolizumab, in combination with etoposide and carboplatin regimen, in the first-line treatment of extensive-stage small-cell lung cancer: a single-center experience

Lee, Seo-Young; Shim, Hyo Sup; Ahn, Beung‐Chul; Lim, Sun Min; Kim, Hye Ryun; Cho, Byoung Chul; Hong, Min Hee

doi:10.1007/s00262-021-03052-w

Cited by 28 publications

(29 citation statements)

References 36 publications

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“…During the maintenance phase, any grade irAEs were prevalent in 36.0%. This result is similar to that of IMpower 133, and Lee et al, in which any grade treatment‐related adverse events was 89.7% and 32.4% patients experienced irAEs 10,24 . In the present study, there was a variety of irAEs which included thyroid disorder, pancreatitis, hepatitis, acute kidney injury, etc.…”

Section: Discussionsupporting

confidence: 91%

“…A meta‐analysis suggested significant correlations between elevated serum LDH and overall survival in patients with SCLC 23 . A study by Lee et al, in which 68 patients with ES‐SCLC under EC‐A combination treatment were included, showed that baseline bone metastasis, IrAEs, and elevated LDH were associated with OS 24 . A question arises if the factors have predictability for platinum‐based regimen or atezolizumab components.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide‐platinum‐atezolizumab treatment

et al. 2022

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Background: The phase III trial IMpower133 showed that platinum and etoposide plus atezolizumab was associated with improved overall survival (OS) and progression free-survival (PFS) when compared to the placebo group in treatment-naïve extensive stage (ES) small cell lung cancer (SCLC). Due to superiority in clinical outcomes, combination immunotherapy plus chemotherapy have become mainstay treatment modalities as first-line treatment in ES-SCLC. Nevertheless, real-world data are still lacking and the search for potential biomarkers is essential. This study aimed to evaluate potential predictive biomarkers applicable in ES-SCLC under combination therapy. Methods: Patients with ES-SCLC under etoposide-platinum-atezolizumab enrolled from seven university hospitals affiliated to the Catholic University of Korea were evaluated. Pretreatment clinical parameters were evaluated for association with OS and PFS. Adverse events (AEs) during induction and maintenance phases were also evaluated. p-values below 0.05 were considered statistically significant. Results: A total of 41 patients were evaluated. Six-month survival was 68.6%. As best response to treatment, 26 (63.4%) showed partial response, nine (22.0%) showed stable disease, and four (9.8%) showed progressive disease. During the induction phase, grade I-II AEs occurred in 22 (53.7%) patients, and grade III-IV AEs occurred in 26 (63.4%) patients. During the maintenance phase, nine out of 25 (36.0%) patients experienced any grade AEs. In multivariate analysis for OS, lactate dehydrogenase

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide‐platinum‐atezolizumab treatment

et al. 2022

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show abstract

“…During the maintenance phase, any grade irAEs were prevalent in 36.0%. This result is similar to that of IMpower 133, and Lee et al, in which any grade treatment-related adverse events was 89.7% and 32.4% patients experienced irAEs 10,24 . In the present study, there were variety of irAEs; thyroid disorder, pancreatitis, hepatitis, acute kidney injury, etc.…”

Section: Discussionsupporting

confidence: 89%

“…A meta-analysis suggested signi cant correlations between elevated serum LDH and overall survival in patients with SCLC 23 . In a study by Lee et al, in which 68 patients with ES-SCLC under the EC-A combination treatment were included showed that baseline bone metastasis, IrAEs, and elevated LDH showed association with OS 24 . A question arises if the factors have predictability for platinum-based regimen or atezolizumab components.…”

Section: Discussionmentioning

confidence: 99%

Investigation of poor prognostic factors in extensive-stage small cell lung cancer under etoposide- platinum-atezolizumab treatment

Lim

Kang

Shin

et al. 2022

Preprint

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The phase III trial IMpower133 showed that platinum and etoposide plus atezolizumab was associated with improved overall survival (OS) and progression free-survival (PFS) when compared to the placebo group in treatment-naïve extensive-stage (ES)-small cell lung cancer (SCLC). Due to superiority in clinical outcomes, combination immunotherapy plus chemotherapy became mainstay treatment modalities as first line treatment in ES-SCLC. Nevertheless, real-world data are still lacking and search for potential biomarkers is necessary. This study aims to evaluate potential predictive biomarkers applicable in ES-SCLC under the combination therapy. Patients with ES-SCLC who are under etoposide-platinum-atezolizumab enrolled from 7 university hospitals affiliated to the Catholic University of Korea were evaluated. Pretreatment clinical parameters were evaluated for association with OS and PFS. Adverse events (AEs) during induction and maintenance phases were also evaluated. P-value below 0.05 was counted as statistically significant. Total of 41 patients were evaluated. Six-month survival was 68.6%. As best response to treatment, 26 (63.4%) showed partial response, 9 (22.0%) showed stable disease, and 4 (9.8%) showed progressive disease. During induction phase, grade I-II AEs occurred in 22 (53.7%) patients, and grade III-IV AEs occurred in 26 (63.4%) patients. During maintenance phase, 9 out of 25 (36.0%) patients experienced any grade AEs. In multivariate analysis for OS, lactate dehydrogenase (LDH), c-reactive protein (CRP), and forced vital capacity (%) were significant factors. In multivariate analysis for PFS, sex, and LDH were significant. In ES-SCLC under etoposide-platinum-atezolizumab, pretreatment CRP, LDH and FVC (%) were independent prognostic factors.

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“…After full-text screening, we selected 2,399 potentially relevant articles. Finally, we identified 30 informative studies, including 16 RCTs ( 9 , 14 , 24 – 37 ) and 14 observational trials ( 12 , 13 , 38 – 49 ) which fulfilled the inclusion criteria ( Table 1 ). A flowchart ( Figure 1 ) demonstrated the study selection process.…”

Section: Resultsmentioning

confidence: 99%

Liver metastases and the efficacy of immune checkpoint inhibitors in advanced lung cancer: A systematic review and meta-analysis

Xia

Zhang²,

Zhang³

et al. 2022

Front. Oncol.

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BackgroundLiver metastasis is the most common type of lung cancer metastasis, and is a significant prognostic factor in lung cancer. However, the effect of liver metastases on the efficacy of immune checkpoint inhibitors (ICIs) remains inconsistent and controversial. The aim of this study was to explore the relationship between liver metastases and ICI efficacy in patients with advanced lung cancer based on data from randomized controlled trials (RCTs) and observational studies.MethodsPubMed, EMBASE, Cochrane Library databases, conference proceedings, as well as grey literature websites were searched for eligible studies without language restrict ion. Study quality was assessed using Cochrane tools and the Newcastle–Ottawa Quality Assessment Scale (NOS). Outcomes of interest were overall survival (OS) and progression-free survival (PFS). The difference in efficacy between patients with and without liver metastases was calculated by pooling ratios of hazard ratios (HR), as calculated using the deft approach.ResultsA total of 16 RCTs and 14 observational trials were included. Analyses of RCTs revealed a survival benefit for ICI treatment (i.e., ICI monotherapy, ICI + Chemotherapy, dual ICI therapy and dual ICI + Chemotherapy) versus standard therapies among non-small cell lung cancer (NSCLC) patients with liver metastases (PFS HR, 0.77; 95%CI, 0.61–0.97; OS HR, 0.78; 95%CI, 0.68–0.90). NSCLC patients with liver metastases achieved less PFS benefit and comparable OS benefit from ICI treatment compared with those without liver metastases (ratios of PFS–HRs, 1.19; 95%CI, 1.02–1.39; P=0.029; Ratios of OS–HRs, 1.10; 95%CI, 0.94–1.29; P=0.24). For patients with small cell lung cancer (SCLC), ICI treatment achieved a marginal effect on patients with liver metastases as compared with standard therapies (OS HR, 0.94; 95%CI, 0.73–1.23). SCLC patients with liver metastases benefited less from ICI treatment than patients without liver metastases (ratio of OS–HRs, 1.22; 95%CI, 1.01–1.46; P=0.036). In real-world data analysis, liver metastasis could be used as an independent prognostic risk factor, increasing the risk of death by 21% in lung cancer patients receiving ICI treatment compared with those without liver metastases (OS HR, 1.21; 95%CI, 1.17–1.27; P<0.0001). Subgroup analysis confirmed that this association was not modified by race (Asian vs. Western) or number of treatment lines.ConclusionsThe presence of liver metastases does not significantly influence the OS benefit of ICIs in patients with NSCLC. However, a small amount of data shows that liver metastasis restrains the magnitude of OS benefit in patients with SCLC. Liver metastasis has potential as an independent prognostic risk factor for lung cancer patients receiving ICI treatment in clinical practice.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022306449).

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Efficacy and safety of atezolizumab, in combination with etoposide and carboplatin regimen, in the first-line treatment of extensive-stage small-cell lung cancer: a single-center experience

Cited by 28 publications

References 36 publications

Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide‐platinum‐atezolizumab treatment

Investigation of poor predictive factors in extensive stage small cell lung cancer under etoposide‐platinum‐atezolizumab treatment

Investigation of poor prognostic factors in extensive-stage small cell lung cancer under etoposide- platinum-atezolizumab treatment

Liver metastases and the efficacy of immune checkpoint inhibitors in advanced lung cancer: A systematic review and meta-analysis

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