A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada
Introduction: The real-world data evaluating treatment outcomes of atezolizumab plus carboplatin-etoposide chemotherapy (atezolizumab) for extensive-stage SCLC (ESCLC) are lacking. Our objective was to evaluate real-world outcomes of ESCLC treated with atezolizumab. Methods: A retrospective analysis...
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| Format: | Article |
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Elsevier
2021-12-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364321001089 |
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| author | Anifat A. Elegbede, MSc, MbChB Amanda J. Gibson, BSc Andrea S. Fung, PhD, MD Winson Y. Cheung, MD, MPH Michelle L. Dean, BSc D. Gwyn Bebb, BMBCh, PhD Aliyah Pabani, MD |
| author_facet | Anifat A. Elegbede, MSc, MbChB Amanda J. Gibson, BSc Andrea S. Fung, PhD, MD Winson Y. Cheung, MD, MPH Michelle L. Dean, BSc D. Gwyn Bebb, BMBCh, PhD Aliyah Pabani, MD |
| author_sort | Anifat A. Elegbede, MSc, MbChB |
| collection | DOAJ |
| description | Introduction: The real-world data evaluating treatment outcomes of atezolizumab plus carboplatin-etoposide chemotherapy (atezolizumab) for extensive-stage SCLC (ESCLC) are lacking. Our objective was to evaluate real-world outcomes of ESCLC treated with atezolizumab. Methods: A retrospective analysis of provincial patients with ESCLC who started first-line (1L) systemic treatment was conducted. We primarily evaluated the progression-free survival (PFS) and overall survival (OS) outcomes in association with atezolizumab compared with platinum-etoposide chemotherapy (chemotherapy) while adjusting for relevant demographic and clinical factors. Adverse events (AEs) during 1L were evaluated. Results: A total of 67 patients were identified. Of the 34 patients who received atezolizumab, 24% had Eastern Cooperative Oncology Group performance status greater than or equal to 2, approximately 50% were more than or equal to 65 years, 21% received cisplatin-etoposide chemotherapy before atezolizumab, and 12% had thoracic radiation (tRT).Within the atezolizumab versus chemotherapy group, the median PFS equals to 6.0 versus 4.3 months (p = 0.03) whereas OS = 12.8 versus 7.1 months (p = 0.01). Relative to chemotherapy, the hazard ratio (95% confidence interval) for PFS was 0.53 (0.28–1.02) and OS was 0.42 (0.20–0.88) with atezolizumab. tRT compared with no tRT receipt correlated with reduced death risk (hazard ratio [95% confidence interval] = 0.33 [0.13–0.88]).AE-related treatment withdrawal with atezolizumab was 32% and 15% with chemotherapy (p = 0.02). Within the tRT subgroup, 25% versus 20% in atezolizumab versus chemotherapy group, respectively, discontinued 1L owing to AE. Conclusions: This is the first real-world study revealing comparable survival with that in the IMpower133 trial. Treatment discontinuation from AEs was higher with atezolizumab among Canadian patients with ESCLC. Our data suggest safe use of tRT and chemoimmunotherapy, but its efficacy for ESCLC warrants further study. |
| first_indexed | 2024-12-19T12:29:28Z |
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| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-12-19T12:29:28Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
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| spelling | doaj.art-6d9518960e1846f9a1d2a211e151b4582022-12-21T20:21:27ZengElsevierJTO Clinical and Research Reports2666-36432021-12-01212100249A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in CanadaAnifat A. Elegbede, MSc, MbChB0Amanda J. Gibson, BSc1Andrea S. Fung, PhD, MD2Winson Y. Cheung, MD, MPH3Michelle L. Dean, BSc4D. Gwyn Bebb, BMBCh, PhD5Aliyah Pabani, MD6Department of Oncology, University of Calgary, Calgary, Alberta, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, CanadaCancer Centre of Southeastern Ontario, Kingston Health Sciences Centre, Kingston, Ontario, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, Canada; Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, Canada; Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, Canada; Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada; Corresponding author. Address for correspondence: Aliyah Pabani, MD, Tom Baker Cancer Center, 1331 29th Street Northwest, Calgary AB T2N 4N2, Canada.Introduction: The real-world data evaluating treatment outcomes of atezolizumab plus carboplatin-etoposide chemotherapy (atezolizumab) for extensive-stage SCLC (ESCLC) are lacking. Our objective was to evaluate real-world outcomes of ESCLC treated with atezolizumab. Methods: A retrospective analysis of provincial patients with ESCLC who started first-line (1L) systemic treatment was conducted. We primarily evaluated the progression-free survival (PFS) and overall survival (OS) outcomes in association with atezolizumab compared with platinum-etoposide chemotherapy (chemotherapy) while adjusting for relevant demographic and clinical factors. Adverse events (AEs) during 1L were evaluated. Results: A total of 67 patients were identified. Of the 34 patients who received atezolizumab, 24% had Eastern Cooperative Oncology Group performance status greater than or equal to 2, approximately 50% were more than or equal to 65 years, 21% received cisplatin-etoposide chemotherapy before atezolizumab, and 12% had thoracic radiation (tRT).Within the atezolizumab versus chemotherapy group, the median PFS equals to 6.0 versus 4.3 months (p = 0.03) whereas OS = 12.8 versus 7.1 months (p = 0.01). Relative to chemotherapy, the hazard ratio (95% confidence interval) for PFS was 0.53 (0.28–1.02) and OS was 0.42 (0.20–0.88) with atezolizumab. tRT compared with no tRT receipt correlated with reduced death risk (hazard ratio [95% confidence interval] = 0.33 [0.13–0.88]).AE-related treatment withdrawal with atezolizumab was 32% and 15% with chemotherapy (p = 0.02). Within the tRT subgroup, 25% versus 20% in atezolizumab versus chemotherapy group, respectively, discontinued 1L owing to AE. Conclusions: This is the first real-world study revealing comparable survival with that in the IMpower133 trial. Treatment discontinuation from AEs was higher with atezolizumab among Canadian patients with ESCLC. Our data suggest safe use of tRT and chemoimmunotherapy, but its efficacy for ESCLC warrants further study.http://www.sciencedirect.com/science/article/pii/S2666364321001089Extensive stage SCLCChemo-immunotherapyThoracic radiationSurvival outcomes |
| spellingShingle | Anifat A. Elegbede, MSc, MbChB Amanda J. Gibson, BSc Andrea S. Fung, PhD, MD Winson Y. Cheung, MD, MPH Michelle L. Dean, BSc D. Gwyn Bebb, BMBCh, PhD Aliyah Pabani, MD A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada JTO Clinical and Research Reports Extensive stage SCLC Chemo-immunotherapy Thoracic radiation Survival outcomes |
| title | A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada |
| title_full | A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada |
| title_fullStr | A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada |
| title_full_unstemmed | A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada |
| title_short | A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada |
| title_sort | real world evaluation of atezolizumab plus platinum etoposide chemotherapy in patients with extensive stage sclc in canada |
| topic | Extensive stage SCLC Chemo-immunotherapy Thoracic radiation Survival outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2666364321001089 |
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