Mustafa Gürbüz1, Yasin Kutlu2, Erman Akkuş3, Elif Berna Köksoy4, Naziyet Köse5, Bala Başak Öven6, Başak Oyan Uluç7, Atike Gökçen Demiray8, Dilek Erdem9, Bilgin Demir10, Nazım Serdar Turhal11, Necdet Üskent11, Sinem Akbaş12, Fatih Selçukbiricik12, Ali İnal13, Ahmet Bilici2, Ömer Fatih Ölmez2, Devrim Çabuk14, Çağlar Ünal15, Mutlu Hızal16, Mehmet Ali Nahit Şendur16, Mustafa Korkmaz17, Nuri Karadurmuş18, İsmail Ertürk18, Sema Sezgin Göksu19, Ali Murat Tatlı19, Deniz Can Güven20, Saadettin Kılıçkap21, Nail Paksoy22, Adnan Aydıner22, Havva Yeşil Çınkır23, Özlem Özkul24, Akın Öztürk25, Sevinç Ballı4, Yasemin Kemal9, Atike Pınar Erdoğan26, Özlem Er27, Perran Fulden Yumuk12, Ahmet Demirkazık4. 1. Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey. mgurbuz@ankara.edu.tr. 2. Department of Medical Oncology, Faculty of Medicine, İstanbul Medipol University, Istanbul, Turkey. 3. Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey. 4. Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey. 5. Department of Medical Oncology, Memorial Ankara Hospital, Ankara, Turkey. 6. Department of Medical Oncology, Faculty of Medicine, Bahçeşehir University, Göztepe Medical Park Hospital, Istanbul, Turkey. 7. Department of Medical Oncology, Acıbadem Altunizade Hospital, Istanbul, Turkey. 8. Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey. 9. Department of Medical Oncology, Samsun Medical Park Hospital, Samsun, Turkey. 10. Department of Medical Oncology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey. 11. Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey. 12. Department of Medical Oncology, Koç University Hospital, Istanbul, Turkey. 13. Department of Medical Oncology, Mersin City Hospital, Mersin, Turkey. 14. Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. 15. Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey. 16. Department of Medical Oncology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey. 17. Meram Faculty of Medicine, Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey. 18. Department of Medical Oncology, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey. 19. Department of Medical Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. 20. Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 21. Department of Medical Oncology, Faculty of Medicine, İstinye University, Liv Ankara Hospital, Ankara, Turkey. 22. Department of Medical Oncology, Faculty of Medicine, İstanbul University, Istanbul, Turkey. 23. Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey. 24. Department of Medical Oncology, Bağcılar Training and Research Hospital, Istanbul, Turkey. 25. Department of Medical Oncology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey. 26. Department of Medical Oncology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey. 27. Department of Medical Oncology, Maslak Acıbadem Hospital, Istanbul, Turkey.
Abstract
PURPOSE: Atezolizumab has been shown to be effective and safe in randomized trial in the first-line treatment of extensive-stage small cell lung cancer (SCLC). However, there are limited real-life data on atezolizumab. In this study, we aimed to determine the real-life efficacy and safety of atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage SCLC. METHODS: This trial is a retrospective multicenter study of the Turkish Oncology Group, which included extensive-stage SCLC patients who received atezolizumab combined with chemotherapy in a first-line treatment. The characteristics of the patients, treatment and response rates, and PFS and OS are presented. Factors associated with PFS and OS were analyzed by univariate and multivariate analysis. RESULTS: A total of 213 patients at the 30 oncology centers were included. The median number of chemotherapy cycle was 5 (1-8) and atezolizumab cycle was 7 (1-32). After median 11.9 months of follow-up, median PFS and OS was 6.8 months (95%CI 5.7-7.8), and 11.9 months (95%CI 11-12.7), respectively. The ORR was 61.9%. ECOG-PS (p = 0.002) and number of metastatic sites (p = 0.001) were associated with PFS and pack-year of smoking (p = 0.05), while ECOG-PS (p = 0.03) and number of metastatic sites (p = 0.001) were associated with OS. Hematological side effects were common and toxicities were manageable. CONCLUSION: This real-life data confirm the efficacy and safety of atezolizumab in combination with chemotherapy in first-line treatment of extensive-stage SCLC.
PURPOSE: Atezolizumab has been shown to be effective and safe in randomized trial in the first-line treatment of extensive-stage small cell lung cancer (SCLC). However, there are limited real-life data on atezolizumab. In this study, we aimed to determine the real-life efficacy and safety of atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage SCLC. METHODS: This trial is a retrospective multicenter study of the Turkish Oncology Group, which included extensive-stage SCLC patients who received atezolizumab combined with chemotherapy in a first-line treatment. The characteristics of the patients, treatment and response rates, and PFS and OS are presented. Factors associated with PFS and OS were analyzed by univariate and multivariate analysis. RESULTS: A total of 213 patients at the 30 oncology centers were included. The median number of chemotherapy cycle was 5 (1-8) and atezolizumab cycle was 7 (1-32). After median 11.9 months of follow-up, median PFS and OS was 6.8 months (95%CI 5.7-7.8), and 11.9 months (95%CI 11-12.7), respectively. The ORR was 61.9%. ECOG-PS (p = 0.002) and number of metastatic sites (p = 0.001) were associated with PFS and pack-year of smoking (p = 0.05), while ECOG-PS (p = 0.03) and number of metastatic sites (p = 0.001) were associated with OS. Hematological side effects were common and toxicities were manageable. CONCLUSION: This real-life data confirm the efficacy and safety of atezolizumab in combination with chemotherapy in first-line treatment of extensive-stage SCLC.