Patient Characteristics and Treatment Patterns in Extensive-Stage Small Cell Lung Cancer (ES-SCLC)
Author(s)
Wade Iams, MD1, Tavvy Miller, PhD2, Samantha Reiss, PharmD, BCOP2, Navit Naveh, MD3, Badri Rengarajan, MD4, Amy M. Nguyen, PhD3, Kristin Moore, PhD3, Xiaozhou Fan, PhD3;
1Tennessee Oncology, Nashville, TN, USA, 2Flatiron Health, New York, NY, USA, 3Jazz Pharmaceuticals, Philadelphia, PA, USA, 4Jazz Pharmaceuticals, Palo Alto, CA, USA
1Tennessee Oncology, Nashville, TN, USA, 2Flatiron Health, New York, NY, USA, 3Jazz Pharmaceuticals, Philadelphia, PA, USA, 4Jazz Pharmaceuticals, Palo Alto, CA, USA
Presentation Documents
OBJECTIVES: Nearly 60-70% of small cell lung cancer (SCLC) patients present with extensive-stage (ES) disease at diagnosis. The current first-line (1L) standard of care for ES-SCLC is platinum-based chemotherapy with immunotherapy (IO) followed by IO maintenance (1Lm). After 1L therapy, subsequent options include lurbinectedin, topotecan, platinum rechallenge (PR), and tarlatamab (since 2024). This study sought to understand current treatment patterns and clinical characteristics of patients with ES-SCLC.
METHODS: This retrospective cohort study identified adult ES-SCLC patients in the nationwide Flatiron Health electronic health record-derived deidentified database. Patients who initiated 1L treatment between 01/2020 - 12/2023 and had ≥5 months of potential follow-up were included.
RESULTS: There were 2,025 ES-SCLC patients identified (mean age: 68 [SD 8.8] years; 52% female). 59% of patients had ECOG 0-1, and 25% had ECOG 2-3 before 1L. Overall, 82% (n=1,658) received IO with platinum-based chemotherapy during 1L; of those, 56% (n=934) received IO 1Lm. Overall, 40% (n=820) of patients received second-line (2L) and 13% (n=230) received third-line (3L) treatments. Patients receiving 1Lm or 2L/3L therapy tend to be younger and healthier than the 1L cohort. The median duration of 1L treatment was 2.1 months (2.8 months among 1Lm patients). The median treatment duration for 2L and 3L was 1.9 and 1.4 months, respectively. Among patients who initiated 2L, 45% had a chemotherapy-free interval <90 days, 30% 91-180 days, and 20% >180 days. The most common 2L regimens were lurbinectedin (45%) and PR with or without IO (28%). The most common 3L regimens were lurbinectedin (32%), topotecan (22%), and IO monotherapy (5.6%).
CONCLUSIONS: ES-SCLC patients receiving 1Lm and subsequent therapy tend to be younger and healthier than the average patients receiving 1L treatment. Lurbinectedin was the most common 2L and 3L treatment. Reasons for not proceeding with treatment intensification in 1L and 1Lm should be further investigated.
METHODS: This retrospective cohort study identified adult ES-SCLC patients in the nationwide Flatiron Health electronic health record-derived deidentified database. Patients who initiated 1L treatment between 01/2020 - 12/2023 and had ≥5 months of potential follow-up were included.
RESULTS: There were 2,025 ES-SCLC patients identified (mean age: 68 [SD 8.8] years; 52% female). 59% of patients had ECOG 0-1, and 25% had ECOG 2-3 before 1L. Overall, 82% (n=1,658) received IO with platinum-based chemotherapy during 1L; of those, 56% (n=934) received IO 1Lm. Overall, 40% (n=820) of patients received second-line (2L) and 13% (n=230) received third-line (3L) treatments. Patients receiving 1Lm or 2L/3L therapy tend to be younger and healthier than the 1L cohort. The median duration of 1L treatment was 2.1 months (2.8 months among 1Lm patients). The median treatment duration for 2L and 3L was 1.9 and 1.4 months, respectively. Among patients who initiated 2L, 45% had a chemotherapy-free interval <90 days, 30% 91-180 days, and 20% >180 days. The most common 2L regimens were lurbinectedin (45%) and PR with or without IO (28%). The most common 3L regimens were lurbinectedin (32%), topotecan (22%), and IO monotherapy (5.6%).
CONCLUSIONS: ES-SCLC patients receiving 1Lm and subsequent therapy tend to be younger and healthier than the average patients receiving 1L treatment. Lurbinectedin was the most common 2L and 3L treatment. Reasons for not proceeding with treatment intensification in 1L and 1Lm should be further investigated.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD69
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology