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

Lionel Falchero; Florian Guisier; Marie Darrason; Arnaud Boyer; Charles Dayen; Sophie Cousin; Patrick Merle; Régine Lamy; Anne Madroszyk; Josiane Otto; Pascale Tomasini; Sandra Assoun; Anthony Canellas; Radj Gervais; José Hureaux; Jacques Le Treut; Olivier Leleu; Charles Naltet; Marie Tiercin; Sylvie Van Hulst; Pascale Missy; Franck Morin; Virginie Westeel; Nicolas Girard

doi:10.1016/j.lungcan.2023.107379

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

Lung Cancer. 2023 Nov:185:107379. doi: 10.1016/j.lungcan.2023.107379. Epub 2023 Sep 22.

Authors

Lionel Falchero¹, Florian Guisier², Marie Darrason³, Arnaud Boyer⁴, Charles Dayen⁵, Sophie Cousin⁶, Patrick Merle⁷, Régine Lamy⁸, Anne Madroszyk⁹, Josiane Otto¹⁰, Pascale Tomasini¹¹, Sandra Assoun¹², Anthony Canellas¹³, Radj Gervais¹⁴, José Hureaux¹⁵, Jacques Le Treut¹⁶, Olivier Leleu¹⁷, Charles Naltet¹⁸, Marie Tiercin¹⁹, Sylvie Van Hulst²⁰, Pascale Missy²¹, Franck Morin²¹, Virginie Westeel²², Nicolas Girard²³

Affiliations

¹ Service de Pneumologie et Cancérologie Thoracique, Hôpitaux Nord-Ouest, Villefranche Sur Saône, France.
² 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.
³ HCL, Centre Hospitalier Lyon Sud, URCC Secteur essais cliniques, Pierre-Bérard, France.
⁴ Hôpital Saint Joseph, Service de Pneumologie, Marseille, Franc'.
⁵ Clinique de l'Europe, Service de Pneumologie, Amiens, France.
⁶ Institut'Bergonié, Département d'Oncologie Médicale, Bordeaux, France.
⁷ CHU, Hôpital Gabriel Montpied, Hôpital de jour, Service d'oncologie Thoracique, Clermont Ferrand, France.
⁸ CHBS, Hôpital Du Scorff, Oncologie médicale, Lorient, France.
⁹ Institut Paoli Calmettes, Département d'Oncologie Médicale, Marseille, France Centre Antoine Lacassagne, Oncologie, Nice, France.
¹⁰ Centre Antoine Lacassagne, Nice, France.
¹¹ APHM, Service d'Oncologie Multidisciplinaire &Franceations Thérapeutiques, Hôpital Nord, Marseille, France.
¹² APHP, Service de Pneumologie, Hôpital Bichat, Paris, France.
¹³ APHP, Service de Pneumologie, Hôpital Tenon, Paris, France.
¹⁴ Service de Pneumol'gie, Centre François Baclesse, Caen, France.
¹⁵ Service de Pneumologie, CHU Angers, Angers, France.
¹⁶ Service de Pneumologie, Hôpital Européen, Marseille, France.
¹⁷ Service de Pneumologie, Centre Hospitalier, Abbeville, France.
¹⁸ Service de Pneumologie Oncologie, Groupe Hospitalier ParisFrance Joseph, Paris, France.
¹⁹ Fédération de Pneumologie, Centre Hospitalier, Saint Malo, France.
²⁰ Service de Cancérologie, Centre Hospitalier Universitaire, Nîmes, France.
²¹ IFCT, Unité de Recherche Clinique, Paris, France.
²² CHU Besançon, Hôpita Minjoz, Service de Pneumologie, Besançon, France.
²³ Institut du Thorax Curie Montsouris, Institut Curie, Paris, France, Paris Saclay University, University Versailles Saint Quentin, Versailles, France. Electronic address: nicolas.girard2@curie.fr.

PMID: 37757576
DOI: 10.1016/j.lungcan.2023.107379

Abstract

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: 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: 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: 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.

Keywords: Chemotherapy; Immunotherapy; Small cell lung cancer; Targeted therapy.