Real-World Treatment Patterns and Outcomes in Patients With Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Treated With First-Line Platinum-Based Chemotherapy (PBC) and =2 Subsequent Lines of Therapy in the United States
Author(s)
Kamya Sankar, MD1, Sudhir Unni, PhD, MBA2, Marian Eberl, MD3, Hoa Le, MD, PhD2, Tara Herrmann, PhD, MBA2, Boris Gorsh, PharmD2, Mei Tang, MD, PhD2, Sajid Ahmed, PharmD2.
1Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA, 2Daiichi Sankyo, Inc., Basking Ridge, NJ, USA, 3Daiichi Sankyo Europe GmbH, Munich, Germany.
1Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA, 2Daiichi Sankyo, Inc., Basking Ridge, NJ, USA, 3Daiichi Sankyo Europe GmbH, Munich, Germany.
Presentation Documents
OBJECTIVES: Recurrent disease is common in patients with ES-SCLC and prognosis is poor, with limited treatment options. Understanding patient characteristics, treatment patterns, and outcomes in this setting may inform clinical development of novel therapies for ES-SCLC.
METHODS: This retrospective, observational cohort study used the nationwide Flatiron Health electronic health record-derived, de‑identified database, which contains data originating from ~280 community and academic cancer clinics in the United States. Adult patients with an ES‑SCLC diagnosis and ≥2 clinical visits recorded in the database from January 1, 2018-July 31, 2023 (data cutoff: January 31, 2024) were included if they received first-line PBC followed by any second‑line and third-line therapies. Patients who received investigational drugs were excluded. Overall survival, time to treatment discontinuation or death (TTD), and time to next treatment or death (TTNT) were assessed using Kaplan-Meier methodology.
RESULTS: Among 2573 patients treated with first-line PBC, 344 received third-line treatment (median age, 66.5 years; male, 51.5%; White, 75.6%; ECOG PS 0/1, 65.4%; treated in community setting, 75.3%). The most common third-line therapies were lurbinectedin monotherapy (received by 21.8% of patients); topoisomerase I inhibitor monotherapy (21.8%); chemotherapy other than platinum-based agents, topoisomerase inhibitors, and lurbinectedin (15.7%); and PD‑(L)1-inhibitor monotherapy (13.1%). From third-line therapy initiation, median overall survival was 4.53 months (95% CI, 3.71-5.39), median TTD was 2.56 months (95% CI, 2.27-2.79), median TTNT was 2.92 months (95% CI, 2.69-3.12), and response rate was 11.7% (95% CI, 5.5-21.0). Data for third-line cohort subgroups (including by chemotherapy-free interval) and treatment patterns across first to fourth lines will be presented.
CONCLUSIONS: This study demonstrates that there is no clear standard of care among patients with ES-SCLC receiving third‑line therapy. Treatment duration is short, and outcomes, including overall survival, are poor, highlighting the substantial disease burden and need for novel treatment options in this patient population.
METHODS: This retrospective, observational cohort study used the nationwide Flatiron Health electronic health record-derived, de‑identified database, which contains data originating from ~280 community and academic cancer clinics in the United States. Adult patients with an ES‑SCLC diagnosis and ≥2 clinical visits recorded in the database from January 1, 2018-July 31, 2023 (data cutoff: January 31, 2024) were included if they received first-line PBC followed by any second‑line and third-line therapies. Patients who received investigational drugs were excluded. Overall survival, time to treatment discontinuation or death (TTD), and time to next treatment or death (TTNT) were assessed using Kaplan-Meier methodology.
RESULTS: Among 2573 patients treated with first-line PBC, 344 received third-line treatment (median age, 66.5 years; male, 51.5%; White, 75.6%; ECOG PS 0/1, 65.4%; treated in community setting, 75.3%). The most common third-line therapies were lurbinectedin monotherapy (received by 21.8% of patients); topoisomerase I inhibitor monotherapy (21.8%); chemotherapy other than platinum-based agents, topoisomerase inhibitors, and lurbinectedin (15.7%); and PD‑(L)1-inhibitor monotherapy (13.1%). From third-line therapy initiation, median overall survival was 4.53 months (95% CI, 3.71-5.39), median TTD was 2.56 months (95% CI, 2.27-2.79), median TTNT was 2.92 months (95% CI, 2.69-3.12), and response rate was 11.7% (95% CI, 5.5-21.0). Data for third-line cohort subgroups (including by chemotherapy-free interval) and treatment patterns across first to fourth lines will be presented.
CONCLUSIONS: This study demonstrates that there is no clear standard of care among patients with ES-SCLC receiving third‑line therapy. Treatment duration is short, and outcomes, including overall survival, are poor, highlighting the substantial disease burden and need for novel treatment options in this patient population.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD155
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology