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Original Articles
- Lung and Thoracic cancer
- The Real-World Outcome of First Line Atezolizumab in Extensive-Stage Small Cell Lung Cancer: A Multicenter Prospective Cohort Study
- Myeong Geun Choi, Yeon Joo Kim, Jae Cheol Lee, Wonjun Ji, In-Jae Oh, Sung Yong Lee, Seong Hoon Yoon, Shin Yup Lee, Jeong Eun Lee, Eun Young Kim, Chang-Min Choi
- Cancer Res Treat. 2024;56(2):422-429. Published online October 23, 2023
- DOI: https://doi.org/10.4143/crt.2023.913
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Abstract
PDF
Supplementary Material
PubReader
ePub - Purpose
The addition of immune checkpoint inhibitors to chemotherapy has improved survival outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). However, their real-world effectiveness remains unknown. Therefore, we investigated the effectiveness of atezolizumab plus chemotherapy in ES-SCLC in actual clinical settings.
Materials and Methods
In this multicenter prospective cohort study, patients with ES-SCLC receiving or scheduled to receive atezolizumab in combination with etoposide and carboplatin were enrolled between June 2021 and August 2022. The primary outcomes were progression-free survival (PFS) and the 1-year overall survival (OS) rate.
Results
A total of 100 patients with ES-SCLC were enrolled from seven centers. Median age was 69 years, and 6% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2. The median PFS was 6.0 months, the 1-year OS rate was 62.2%, and the median OS was 13.5 months. An ECOG PS of 2-3 and progressive disease as the best response were poor prognostic factors for PFS, while an ECOG PS of 2-3 and brain metastasis were associated with poor prognosis for OS. In addition, consolidative thoracic radiotherapy was found to be an independent favorable prognostic factor for OS (hazard ratio, 0.336; p=0.021). Grade ≥ 3 treatment-related adverse events were observed in 7% of patients, with treatment-related deaths occurring in 2% of patients.
Conclusion
We provided evidence of the favorable real-world effectiveness and safety of atezolizumab plus chemotherapy in ES-SCLC patients, including in the elderly and those with poor ECOG PS. Additional consolidative thoracic radiotherapy may also benefit ES-SCLC patients. -
Citations
Citations to this article as recorded by
- Real-World Treatment Patterns and Clinical Outcomes in Patients With Extensive-Stage Small Cell Lung Cancer Treated With First-Line Platinum-Based Chemotherapy and ≥ 2 Subsequent Lines of Therapy in the United States
Kamya Sankar, Sudhir Unni, Marian Eberl, Hoa Le, Tara Herrmann, Boris Gorsh, Mei Tang, Friso Coerts, Sajid Ahmed
Advances in Therapy.2026; 43(1): 214. CrossRef - Atezolizumab in the first-line treatment of small cell lung cancer: Toxicity and safety in real-world clinical practice
Ju. S. Mansurova, M. A. Lyadova, E. A. Denisova, E. S. Kuzmina, V. К. Lyadov
Meditsinskiy sovet = Medical Council.2026; (21): 20. CrossRef - Atezolizumab plus platinum-based chemotherapy and etoposide as first-line treatment for metastatic small cell lung cancer: a retrospective multicenter observational study
Laura Moñino Domínguez, Laura Amaro Álvarez, Alicia Aguado Paredes, Isabel María Carrión Madroñal
Farmacia Hospitalaria.2026;[Epub] CrossRef - Real-World Evidence of Atezolizumab Efficacy as Part of First-Line Treatment for Extensive-Stage SCLC in Bulgaria
Manoela Manova, Boryana Ivanova, Rositsa Krasteva, Nikolay Conev, Tanya Zlatanova, Jeliazko Arabadjiev, Natalia Chilingirova, Mila Petrova, Assen Dudov, Bozhil Robev, Velko Minchev, Ivan Tonev, Krassimir Koynov, Daniel Penchev, Todor Georgiev, Antoan Rang
Cancers.2026; 18(7): 1129. CrossRef - [Artículo traducido] Atezolizumab más quimioterapia con platino y etopósido como tratamiento de primera línea en cáncer de pulmón microcítico metastásico: estudio multicéntrico observacional retrospectivo
Laura Moñino Domínguez, Laura Amaro Álvarez, Alicia Aguado Paredes, Isabel María Carrión Madroñal
Farmacia Hospitalaria.2026;[Epub] CrossRef - First-Line Serplulimab in Extensive-Stage Small Cell Lung Cancer
Jingjing Liu, Liang Han, Lin Wu, Jun Chen, Hongmei Sun, Guilan Wen, Yinghua Ji, Jianhua Shi, Zhijie Pan, Jinsheng Shi, Xicheng Wang, Yuansong Bai, Yueyin Pan, Xuhong Min, Maksym Viguro, Xingya Li, Yanqiu Zhao, Junquan Yang, Tamta Makharadze, Ekaterine Ark
JAMA Oncology.2026;[Epub] CrossRef - Significance of Platinum‐Based Chemotherapy With Programmed Death‐1 Blockade in Limited Disease Small Cell Lung Cancer: A Retrospective Study
Ayako Shiono, Hisao Imai, Kyoichi Kaira, Takanori Abe, Yuki Sato, Ken Yamamoto, Hiroki Watanabe, Yuko Tsuchiya‐Kawano, Akihiro Tamiya, Takashi Osaki, Noriko Yanagitani, Shigeru Tanzawa, Toshiyuki Sumi, Kohei Yoshimine, Yohei Matsui, Satoshi Endo, Kazuhiko
Thoracic Cancer.2025;[Epub] CrossRef - Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
Mehmet Nuri Baser, Bilgin Demir, Gamze Serin Ozel, Gamze Gokoz Dogu, Serdar Karakaya, Mucahit Ugar, Naziye Ak, Ahmet Ozveren, Ufuk Camanlı, Olcun Umit Unal, Merve Turan, Esin Oktay
Medicina.2025; 61(7): 1230. CrossRef - Extended Follow‐Up Analysis of First‐Line Atezolizumab in Extensive‐Stage Small Cell Lung Cancer: A Real‐World Multicenter Prospective Cohort Study
Yechan Song, Myeong Geun Choi, Yeon Joo Kim, Jae Cheol Lee, Wonjun Ji, In‐Jae Oh, Sung Yong Lee, Seong Hoon Yoon, Shin Yup Lee, Jeong Eun Lee, Eun Young Kim, Ho Young Kim, Chang‐Min Choi
Thoracic Cancer.2025;[Epub] CrossRef
- Real-World Treatment Patterns and Clinical Outcomes in Patients With Extensive-Stage Small Cell Lung Cancer Treated With First-Line Platinum-Based Chemotherapy and ≥ 2 Subsequent Lines of Therapy in the United States
- 7,803 View
- 308 Download
- 6 Web of Science
- 9 Crossref
- Final Report on Real-World Effectiveness of Sequential Afatinib and Osimertinib in EGFR-Positive Advanced Non–Small Cell Lung Cancer: Updated Analysis of the RESET Study
- Taeyun Kim, Tae Won Jang, Chang Min Choi, Mi-Hyun Kim, Sung Yong Lee, Yoon Soo Chang, Kye Young Lee, Seung Joon Kim, Sei Hoon Yang, Jeong Seon Ryu, Jeong Eun Lee, Shin Yup Lee, Chan Kwon Park, Sang Hoon Lee, Seung Hun Jang, Seong Hoon Yoon, Hyung-Joo Oh
- Cancer Res Treat. 2023;55(4):1152-1170. Published online May 19, 2023
- DOI: https://doi.org/10.4143/crt.2023.493
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Abstract
PDFSupplementary MaterialPubReaderePub
- Purpose
This study aimed to report the final analysis of time-on-treatment (TOT) and overall survival (OS) in patients with advanced-stage epidermal growth factor receptor (EGFR)+ non–small cell lung cancer (NSCLC) who received sequential afatinib and osimertinib and to compare the outcomes with other second-line regimens (comparator group).
Materials and Methods
In this updated report, the existing medical records were reviewed and rechecked. TOT and OS were updated and analyzed according to clinical features using the Kaplan-Meier method and log-rank test. TOT and OS were compared with those of the comparator group, in which most patients received pemetrexed-based treatments. A multivariable Cox proportional hazard model was used to evaluate features that could affect survival outcomes.
Results
The median observation time was 31.0 months. The follow-up period was extended to 20 months. A total of 401 patients who received first-line afatinib were analyzed (166 with T790M+ and second-line osimertinib, and 235 with unproven T790M and other second-line agents). Median TOTs on afatinib and osimertinib were 15.0 months (95% confidence interval [CI], 14.0 to 16.1) and 11.9 months (95% CI, 8.9 to 14.6), respectively. The median OS in the osimertinib group was 54.3 months (95% CI, 46.7 to 61.9), much longer than that in the comparator group. In patients who received osimertinib, the OS was longest with Del19+ (median, 59.1; 95% CI, 48.7 to 69.5).
Conclusion
This is one of the largest real-world studies reporting the encouraging activity of sequential afatinib and osimertinib in Asian patients with EGFR+ NSCLC who acquired the T790M mutation, particularly Del19+. -
Citations
Citations to this article as recorded by- Real-World Outcomes of Sequential Afatinib and Osimertinib Versus Afatinib and Chemotherapy in EGFR-Mutant NSCLC: Taiwan Multicenter GIANT Study
How-Wen Ko, Ying-Ting Liao, Sheng-Kai Liang, Yen-Hsiang Huang, Yu-Ching Lin, Ping-Chi Liu, Chin-Chou Wang, Jeng-Shiuan Tsai, Yuh-Min Chen, Jin-Yuan Shih, Tsung-Ying Yang, Cheng-Ta Yang
Targeted Oncology.2026; 21(2): 213. CrossRef - Clinical impact of local consolidative therapy in EGFR-mutant metastatic NSCLC: A propensity-matched multicenter analysis
Eun Hye Lee, Mi-Hyun Kim, Da Hyun Kang, Jisu Moon, Se Hyun Kwak, Jung Seop Eom, Jeong Eun Lee, Chi Young Kim, Yoon Soo Chang, Sang Hoon Lee, Eun Young Kim, Chang Young Lee, Jaeho Cho
Lung Cancer.2026; 217: 109423. CrossRef - KEAP1-NRF2 Pathway as a Novel Therapeutic Target for EGFR-Mutant Non-small Cell Lung Cancer
Jae-Sun Choi, Hye-Min Kang, Kiyong Na, Jiwon Kim, Tae-Woo Kim, Junyang Jung, Heejin Lim, Hyewon Seo, Seung Hyeun Lee
Tuberculosis and Respiratory Diseases.2025; 88(1): 138. CrossRef -
J-REGISTER: real-world study of Japanese patients with
EGFR
mutation-positive NSCLC treated with first-line afatinib
Teppei Yamaguchi, Haruko Daga, Hisashi Tanaka, Takashi Kijima, Masaya Mizushima
Future Oncology.2025; 21(16): 2039. CrossRef - A real-world cohort study of first-line afatinib in patients with EGFR-mutant advanced non-small cell lung cancer in Vietnam
Cam Phuong Pham, Thi Thai Hoa Nguyen, Anh Tu Do, Tuan Khoi Nguyen, Thi Anh Thu Hoang, Tuan Anh Le, Dinh Thy Hao Vuong, Dac Nhan Tam Nguyen, Van Khiem Dang, Thi Oanh Nguyen, Van Luan Pham, Minh Hai Nguyen, Thi Huyen Trang Vo, Hung Kien Do, Ha Thanh Vu, Thi
BMC Cancer.2024;[Epub] CrossRef - Real‐world evidence of brigatinib as second‐line treatment after crizotinib for ALK+ non‐small cell lung cancer using South Korean claims data (K‐AREAL)
Jeong Eun Lee, Jin Hyun Nam, Sun Hong Kwon, Bo Kyung Kim, Seung Min Ha
Cancer Medicine.2024;[Epub] CrossRef - Serum Concentrations of IGF-1R, ERK2, and EGFR and Their Clinical Significance in Patients with Neuroendocrine Tumors
Roksana Duszkiewicz, Janusz Strzelczyk, Elżbieta Chełmecka, Joanna Katarzyna Strzelczyk
Applied Sciences.2024; 14(16): 6998. CrossRef - Optimal first-line treatment for EGFR-mutated NSCLC: a comparative analysis of osimertinib and second-generation EGFR-TKIs
Hsu-Yuan Chen, Chia-Hung Chen, Wei-Chih Liao, Yu-Chao Lin, Hung-Jen Chen, Te-Chun Hsia, Wen-Chien Cheng, Chih-Yen Tu
BMC Pulmonary Medicine.2024;[Epub] CrossRef - Osimertinib as Second- and ≥Third-Line Treatment in Advanced and Recurrence EGFR-Mutant NSCLC Patients Harboring Acquired T790M Mutation
Mu-Han Peng, Yen-Hsiang Huang, Kuo-Hsuan Hsu, Jeng-Sen Tseng, Po-Hsin Lee, Kun-Chieh Chen, Gee-Chen Chang, Tsung-Ying Yang
Cancers.2024; 16(24): 4174. CrossRef - Effectiveness of first-line anticancer treatment may predict treatment response in further lines in stage III/IV patients with non-small cell lung cancer
Monika Bratova, Jana Skrickova, Magda Matusikova, Karolina Hrabcova, Libor Havel, Leona Koubkova, Michal Hrnciarik, Jana Krejci, Ondrej Fischer, Martin Svaton, Kristian Brat
Journal of Cancer Research and Clinical Oncology.2023; 149(19): 17123. CrossRef
- Real-World Outcomes of Sequential Afatinib and Osimertinib Versus Afatinib and Chemotherapy in EGFR-Mutant NSCLC: Taiwan Multicenter GIANT Study
- 8,449 View
- 334 Download
- 7 Web of Science
- 10 Crossref
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