Real-World Treatment Patterns and Outcomes Among Patients With SCLC

Findings from a systematic review show treatment patterns and short outcomes among patients with small-cell lung cancer (SCLC) have remained constant over the 20-year study period from January 2000 to March 2020 (J Thorac Dis. 2021; 13[6]:3692-3707. doi:10.21037/jtd-20-3034).

SCLC is associated with poor survival outcomes and high symptom burdens and accounts for a significant percentage of all lung cancer diagnoses. 

“This study employed a broad, systematic search strategy and timeframe to identify evidence on real-world treatment patterns and outcomes for SCLC outside the USA,” wrote Sukhvinder Johal, AstraZeneca, Cambridge, UK, and colleagues, adding “including understanding sub-populations such as extensive-stage or limited-stage disease.”

Dr Johal and colleagues identified 100 studies on real-world treatment outcomes in patients with SCLC using MEDLINE, Embase, and EBM reviews. The selected studies, conference abstracts, and posters were published or presented between January 1, 2000 and March 1, 2020.

Of the studies selected, 54 were available as full-text articles, and 43 were presented as abstracts or posters. Most studies (80%) reported treatment in the first-line setting. Platinum-based chemotherapy and chemoradiotherapy was the most commonly used treatment. Though first-line treatments had a high response rate, most patients relapsed early.

Immune-oncology therapy treatments and outcomes were not reported in any of the studies. Second-line treatment options mostly consisted of re-treatment with a first-line regimen or topotecan, resulting in poor prognosis for patients. Extensive-stage or relapsed disease was associated with particularly poor outcomes, when compared to limited-stage disease. 

“SCLC treatment patterns and short survival outcomes have remained constant over the previous 20 years.” concluded Dr Johal and colleagues, adding, “Due to the search timeframe, none of the studies identified reported on the impact of recently approved immune-oncology therapies in SCLC.”—Marta Rybczynski