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Evolution of Diagnosis and Treatment of SCLC Over the Last 20 Years
While there has been an increase in the use of carboplatin and brain imaging at diagnosis in patients with small cell lung cancer (SCLC) between the years 2000 and 2021, these efforts have not demonstrated a significant impact on survival, according to a study presented at the virtual ESMO Congress 2021.
The standard systemic treatment for patients with SCLC changed recently, introducing immunotherapy to the standard first-line treatment.
“We aimed to evaluate changed in the clinical management of patients with SCLC during the last decade compared to the previous one in a real-world setting,” wrote Alejandro Rios Hoyo, MD, MSc, Medical Oncology Department, Hospital del Mar - Parc de Salut Mar, Barcelona, Spain, and colleagues.
Dr Rios Hoyo and colleagues gathered data from their institution, Hospital del Mar Parc de Salut Maron, on patients with SCLC from 2000 to 2021. Patients from 2000 to 2010 were placed into cohort 1, and patients from 2011 to 2021 were placed into cohort 2.
Disease stage, assessment for brain metastases at diagnosis, presence of brain and liver metastases, use of prophylactic cranial irradiation, and platinum agent as first-line chemotherapy were examined.
Of the 303 patients included in this retrospective study, those diagnosed with stage IV totaled 64.7% of patients in cohort 1, and 70.6% of patients in cohort 2, demonstrating no statistically significant differences between the cohorts concerning disease staging (P = .675). Liver metastases at diagnosis was more prevalent in cohort 2 at 31.8% vs 20.6% in cohort 2 (P = .043). From cohort 1 to cohort 2, the brain imaging at diagnosis increased from 62.8% to 89.5% (P <.001).
The use of PCI was at 33.3% in cohort 1, and 30.8% in cohort 2. The use of cisplatin was 40.2% in cohort 1, and 19.9% in cohort 2. Use of carboplatin was 44.1% in cohort 1, and 67.7% in cohort 2. No significant differences in median overall survival were apparent in stage III patients (13.96 months for cohort 1 vs) 15.29 months for cohort 2), nor for stage IV patients, who had a median overall survival of 5.24 months, vs 7.01 months in cohort 1 and cohort 2, respectively (P = .832).
“An increase in the use of carboplatin, as well as more frequent brain imaging at diagnosis have been incorporated in the more recent management of patients with SCLC,” concluded Dr Rios Hoyo and colleagues, adding, “However, this has not translated into a significant impact on survival.”
Rios Hoyo A, Hardy-Werbin M, Navarro N, et al. Changes in the pattern of diagnosis and treatment of patients with SCLC in the last 20 years. Presented at: the ESMO Virtual Congress 2021; September 16-21, 2020; virtual. Abstract 1660P.
