Significance of Platinum‐Based Chemotherapy With Programmed Death‐1 Blockade in Limited Disease Small Cell Lung Cancer: A Retrospective Study

TL;DR

This study shows that combining platinum-based chemotherapy with PD-1 blockade is effective and safe for treating recurrent limited disease small cell lung cancer after chemoradiotherapy.

Contribution

The study provides new evidence on the efficacy and safety of chemoimmunotherapy for recurrent limited disease small cell lung cancer.

Findings

The overall response rate was 53.0% and disease control rate was 78.7%.

Median progression-free survival was 5.9 months and overall survival was 24.9 months.

Common grade ≥3 adverse events included neutropenia (65.2%) and leukopenia (47.0%).

Abstract

The efficacy and safety of platinum‐based chemotherapy with programmed death‐1 (PD‐1) blockade after chemoradiotherapy (CRT) for the treatment of limited disease (LD) small cell lung cancer (SCLC) is unknown. This study aimed to assess the effectiveness and tolerability of platinum‐based chemotherapy with PD‐1 blockade in patients with recurrent LD‐SCLC after CRT.

This retrospective study analyzed 66 patients who experienced recurrence after CRT for LD‐SCLC and received platinum‐based chemotherapy with PD‐1 blockade therapy between August 2019 and September 2020 at 19 Japanese institutions. Clinical efficacy was assessed according to response rate, survival, and toxicity.

The overall response rate was 53.0% (95% confidence interval [CI], 48.9–65.0), and the disease control rate was 78.7% (95% CI, 68.9–88.5). The median progression‐free survival and overall survival periods were 5.9 (95% CI, 4.7–7.3) months and 24.9 (95% CI, 16.8–28.1) months, respectively. The frequencies of grade ≥ 3 hematological adverse events were as follows: leukopenia, 47.0%; neutropenia, 65.2%; and febrile neutropenia, 8.3%. There was no treatment‐related death.

Chemoimmunotherapy is a feasible and effective treatment for recurrent disease after CRT in patients with LD‐SCLC, providing a new potential option for the pharmacological management of these patients.

The median progression‐free survival and overall survival periods were 5.9 (95% CI, 4.7–7.3) and 24.9 (95% CI, 16.8–28.1) months, respectively. Chemoimmunotherapy is an effective treatment for recurrent disease after chemoradiotherapy in patients with limited disease small cell lung cancer.

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