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Lung Cancer. 2019 Jan;127:53-58. doi: 10.1016/j.lungcan.2018.11.009. Epub 2018 Nov 8.

Real-world treatment patterns and outcomes of patients with small cell lung cancer progressing after 2 lines of therapy.

Author information

1
Xcenda, LLC, 4114 Woodlands Parkway, Suite 500, Palm Harbor, FL, 34685, USA.
2
AbbVie Inc., 1 North Waukegan Rd, Dept. GMH1, Bldg. ABV1, North Chicago, IL, 60064, USA. Electronic address: manan.shah@abbvie.com.

Abstract

OBJECTIVES:

To evaluate treatment patterns, physician-assessed overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) among third-line (3L)-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 3L, fourth-line (4L), and fifth-line (5L) settings. ORR, PFS, and OS were evaluated for each line of systemic therapy and OS was also evaluated for BSC.

RESULTS:

334 3L 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 3L patients, 41% and 12% went on to 4L and 5L, respectively. ORR for systemic therapy in 3L and 4L averaged around 21% while 5L was 12%. Median PFS in 3L systemic therapy was 2.3 months (95% confidence interval [CI]: 1.9, 2.5), which decreased in 4L and 5L. Median OS for 3L 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 3L BSC was 0.9 months (95% CI: 0.6, 1.2), with 9% survival rate at 6 months.

CONCLUSION:

Current treatments utilized in the 3L-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.

KEYWORDS:

Best supportive care; Oncology EMR; Overall survival; Progression-free survival; Real-world; Small cell lung cancer

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