Real-world Treatment Patterns and Outcomes of Patients with Small Cell Lung Cancer Progressing after 2 Lines of Therapy
Menée aux Etats-Unis à partir des données des dossiers médicaux de 334 patients atteints d'un cancer du poumon à petites cellules, cette étude rétrospective analyse les statégies thérapeutiques dispensées en troisième ligne et au-delà, puis évalue l'efficacité de ces traitements en termes de taux de réponse globale, de survie sans progression et de survie globale
Objectives : To evaluate treatment patterns, physician-assessed overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) among third-line (3 L)-plus small cell lung cancer (SCLC) patients. Materials and methods : Retrospective analysis of a United States (US)-based community oncology electronic medical record (EMR) database was conducted. Target sample included SCLC patients ≥18 years of age whose disease progressed after at least 2 prior treatments. Treatment patterns captured systemic therapy and best supportive care (BSC) in 3 L, fourth-line (4 L), and fifth-line (5 L) settings. ORR, PFS, and OS were evaluated for each line of systemic therapy and OS was also evaluated for BSC. Results : 334 3 L SCLC patients received systemic therapy (n = 249) or BSC (n = 85). Mean age (standard deviation [SD]) was 63.7 (9.5), with 72% having extensive disease at initiation of first-line therapy. Of 3 L patients, 41% and 12% went on to 4 L and 5 L, respectively. ORR for systemic therapy in 3 L and 4 L averaged around 21% while 5 L was 12%. Median PFS in 3 L systemic therapy was 2.3 months (95% confidence interval [CI]: 1.9, 2.5), which decreased in 4 L and 5 L. Median OS for 3 L systemic therapy was 4.4 months (95% CI: 4.0, 5.5), with 6- and 12-month survival rates of 37% and 11%, respectively. In contrast, median OS for 3 L BSC was 0.9 months (95% CI: 0.6, 1.2), with 9% survival rate at 6 months. Conclusion : Current treatments utilized in the 3 L-plus setting yield limited survival benefit. Furthermore, patients left untreated and placed on BSC typically live less than 1 month. New therapeutic options are thus needed for these patients, where no approved options exist.
Lung Cancer 2018