Atezolizumab Plus Etoposide and Carboplatin Delays CNS Progression for Patients With Extensive-Stage Small Cell Lung Cancer
According to results from a retrospective, real-world study, atezolizumab plus etoposide and carboplatin delayed time to central nervous system (CNS) progression among patients with extensive-stage small cell lung cancer (ES-SCLC).
“The combination of atezolizumab with etoposide and carboplatin has become a new standard of care for [ES-SCLC],” stated Kyoungmin Lee, Korea University Guro Hospital, Seoul, South Korea, and coauthors. “This study evaluates its impact on central nervous system progression, specifically brain metastases.”
In this study, researchers collected data from 550 patients with ES-SCLC who received either first-line atezolizumab plus etoposide and carboplatin (n = 247) or conventional chemotherapy (n = 303). Patients with baseline brain metastases (n = 408) who underwent prophylactic cranial irradiation (n = 394) were included. Primary end points included time to intracranial progression, progression-free survival (PFS), and overall survival (OS).
At a median follow-up of 27.8 months, median time to intracranial progression was 24.4 months in the atezolizumab plus etoposide and carboplatin arm and 14.3 months in the chemotherapy arm (P = .038). Among patients with baseline brain metastases, median time to intracranial progression was 27.2 months and 15.3 months (P = .016), respectively. When patients who underwent prophylactic cranial irradiation were excluded, median time to intracranial progression was 27.2 months in the atezolizumab plus etoposide and carboplatin arm and 15.2 months in the chemotherapy arm (P = .02). Median PFS was 5 months in the atezolizumab plus etoposide and carboplatin arm and 4.7 months in the chemotherapy arm (P = .004) and median OS was 11.1 months and 9.8 months (P = .003), respectively.
“Our findings suggest that the [atezolizumab plus etoposide and carboplatin] regimen is superior to conventional chemotherapy in delaying CNS progression and controlling systemic disease in ES-SCLC,” concluded Dr Lee et al. “Further research is needed to explore the mechanisms behind these improved CNS outcomes and to reassess the necessity of [prophylactic cranial irradiation] in this treatment era.”
Source:
Lee K, Kim TH, Lee SY, et al. Delayed central nervous system progression with atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer (LU23-15). Clin Lung Cancer. Published online: February 19, 2025. doi: 10.1016/j.lungcan.2025.108455
