Effectiveness of first-line therapy for metastatic small-cell lung cancer: real-world data
Background. Small cell lung cancer (SCLC) accounts for about 15% of all lung cancer cases. It is characterized by aggressive progression, high proliferative capacity, and early hematogenous and lymphogenous dissemination. Although there is a significant baseline sensitivity to first-line chemotherapy, the majority of patients experience disease progression within 6 to 12 months following treatment initiation, with a median overall survival of approximately 12 months. Aim. To evaluate the efficacy and safety of first-line therapy utilizing atezolizumab combined with carboplatin or cisplatin and etoposide in patients diagnosed with SCLC in a real-world context. Materials and methods. This retrospective and prospective observational study included 157 patients (119 males and 38 females) aged 32 to 84 years. Compromised performance status (ECOG 2–3) at baseline was observed in 54 patients (34.4%). Results. The median progression-free survival in patients with SCLC undergoing first-line therapy was 6.18 months (95% confidence interval [CI] 5.69-6.90), while the median overall survival was 10.55 months (95% CI 8.12-13.02). An objective response was recorded in 82 patients (52.3%). Grade 3–4 immune-related adverse events were documented in only 5.1% of the patient population. Conclusion. The combination of atezolizumab with platinum-based chemotherapy and etoposide as a first-line treatment for SCLC demonstrates high efficacy and an acceptable safety profile in real-world clinical settings.