Management of patients with extensive small-cell lung cancer in the immunotherapy era: an Italian consensus through a Delphi approach

Giovanni Luca Ceresoli; Giulio Rossi; Francesco Agustoni; Lucia Bonomi; Paolo Borghetti; Alessandra Bulotta; Clelia Casartelli; Giulio Cerea; Francesca Colonese; Ester Del Signore; Giovanna Finocchiaro; Letizia Gianoncelli; Salvatore Grisanti; Martina Maiolani; Fabio Pagni; Claudia Proto; Erika Rijavec; Isabella Vittimberga; Stefano Arcangeli; Andrea Riccardo Filippi

doi:10.1016/j.critrevonc.2023.104247

Management of patients with extensive small-cell lung cancer in the immunotherapy era: an Italian consensus through a Delphi approach

Crit Rev Oncol Hematol. 2024 Jan 31:104247. doi: 10.1016/j.critrevonc.2023.104247. Online ahead of print.

Authors

Giovanni Luca Ceresoli¹, Giulio Rossi², Francesco Agustoni³, Lucia Bonomi⁴, Paolo Borghetti⁵, Alessandra Bulotta⁶, Clelia Casartelli⁷, Giulio Cerea⁸, Francesca Colonese⁹, Ester Del Signore¹⁰, Giovanna Finocchiaro¹¹, Letizia Gianoncelli¹², Salvatore Grisanti¹³, Martina Maiolani¹⁴, Fabio Pagni¹⁵, Claudia Proto¹⁶, Erika Rijavec¹⁷, Isabella Vittimberga¹⁸, Stefano Arcangeli¹⁹, Andrea Riccardo Filippi²⁰

Affiliations

¹ Department of Medical Oncology, Humanitas Gavazzeni Hospital, Bergamo, Italy. Electronic address: giovanni.ceresoli@asst-valleolona.it.
² Pathology Unit, Hospital Institute Fondazione Poliambulanza, Via Bissolati 57, 25124 Brescia, Italy.
³ Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy; Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁴ Unit of Oncology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
⁵ Radiation Oncology Department, ASST Spedali Civili and University of Brescia, Brescia, Italy.
⁶ Department of Oncology, IRCCS San Raffaele, via Olgettina 60, Milan, Italy.
⁷ Unit of Oncology, Valduce Hospital, Como, Italy.
⁸ Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
⁹ ASST San Gerardo Monza, Medical Oncology Unit, Monza, Italy.
¹⁰ Division of Thoracic Oncology, European Institute of Oncology, IEO, Milan, Italy.
¹¹ Medical Oncology and Hematologic Unit, Humanitas Cancer Center, Istituto Clinico Humanitas-IRCCS, Rozzano, Italy.
¹² Medical Oncology Unit, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy.
¹³ Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy.
¹⁴ U.O.C Oncologia Medica ASST Valtellina e Alto Lario, Sondrio, Italy.
¹⁵ Pathology, Department of Medicine and Surgery, University Milan Bicocca, Via Cadore 48, 20900 Monza.
¹⁶ Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
¹⁷ Unit of Medical Oncology, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy.
¹⁸ Oncology Department, Ospedale A. Manzoni, Lecco, Italy.
¹⁹ Department of Radiation Oncology, University of Milan Bicocca, Milan, Italy.
²⁰ Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

PMID: 38307393
DOI: 10.1016/j.critrevonc.2023.104247

Abstract

Background: Immunotherapy represented a turning point for treating extensive small-cell lung cancer (ES-SCLC). Although, many issues remain debated.

Methods: A group of Italian medical and radiation oncologists with expertise in managing patients with ES-SCLC developed a list of statements divided in six areas of interest. The Delphi method was used to assess the consensus on the defined list of statements.

Results: 32 statements were included in the final list to be voted by the Delphi panel, and 26 reached a consensus on the agreement. A prompt involvement of a multidisciplinary team is a priority to provide an integrated treatment strategy. First-line recommended treatment is immunotherapy in combination with platinum-based chemotherapy and etoposide for four cycles followed by maintenance immunotherapy.

Conclusions: While awaiting new data from clinical trials and real-world studies, these recommendations can represent a useful tool to guide the management of ES-SCLC patients in daily practice.

Keywords: SCLC; Small-cell lung cancer; immunotherapy; patient management.

Publication types

Review