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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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Extensive stage SCLC Chemo-immunotherapy Thoracic radiation Survival outcomes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/6d9518960e1846f9a1d2a211e151b458
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spelling	oai:doaj.org-article:6d9518960e1846f9a1d2a211e151b4582021-11-28T04:38:43ZA Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada2666-364310.1016/j.jtocrr.2021.100249https://doaj.org/article/6d9518960e1846f9a1d2a211e151b4582021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666364321001089https://doaj.org/toc/2666-3643Introduction: 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.Anifat A. Elegbede, MSc, MbChBAmanda J. Gibson, BScAndrea S. Fung, PhD, MDWinson Y. Cheung, MD, MPHMichelle L. Dean, BScD. Gwyn Bebb, BMBCh, PhDAliyah Pabani, MDElsevierarticleExtensive stage SCLCChemo-immunotherapyThoracic radiationSurvival outcomesNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJTO Clinical and Research Reports, Vol 2, Iss 12, Pp 100249- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Extensive stage SCLC Chemo-immunotherapy Thoracic radiation Survival outcomes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Extensive stage SCLC Chemo-immunotherapy Thoracic radiation Survival outcomes Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 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
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.
format	article
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
title	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_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_sort	real-world evaluation of atezolizumab plus platinum-etoposide chemotherapy in patients with extensive-stage sclc in canada
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/6d9518960e1846f9a1d2a211e151b458
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A Real-World Evaluation of Atezolizumab Plus Platinum-Etoposide Chemotherapy in Patients With Extensive-Stage SCLC in Canada

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