Outcomes with immune checkpoint inhibitors for relapsed small-cell lung cancer in a Swiss cohort

• Published in: Cancer Immunology, Immunotherapy Vol. 69; no. 8; pp. 1605 - 1613
• Main Authors: Schmid, Sabine, Mauti, Laetitia A., Friedlaender, Alex, Blum, Veronika, Rothschild, Sacha I., Bouchaab, Hasna, Frösch, Patrizia, Britschgi, Christian, König, David, Wannesson, Luciano, Janthur, Wolf-Dieter, Schär, Sämi, Demmer, Izadora, Addeo, Alfredo, Jochum, Wolfram, Früh, Martin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2020; Springer Nature B.V
• Subjects: Adult; Aged; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - analysis; Cancer Research; Clinical trials; Female; Follow-Up Studies; Humans; Immune checkpoint inhibitors; Immunology; Immunotherapy - mortality; Ipilimumab - administration & dosage; Lung cancer; Lung carcinoma; Lung Neoplasms - drug therapy; Lung Neoplasms - immunology; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - immunology; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Nivolumab - administration & dosage; Oncology; Original; Original Article; Patients; Prognosis; Radiation; Retrospective Studies; Small cell lung carcinoma; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - immunology; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Survival Rate; Switzerland; Targeted cancer therapy; Switzerland; SCLC; Biomarker; Real-life cohort; Checkpoint inhibitor treatment; Outcome
• ISSN: 0340-7004; 1432-0851
• DOI: 10.1007/s00262-020-02565-0

Objectives Early clinical trials showed promising outcomes with immune-checkpoint inhibitors (ICI) in a subset of patients with relapsed small-cell lung carcinoma (SCLC). The aim of this retrospective analysis was to assess the efficacy and safety of ICI for relapsed SCLC in a real-world patient population. Methods Nine cancer centres in Switzerland contributed data to this cohort. Responses were assessed by the local investigators using standard RECIST v1.1 criteria. Progression-free survival (PFS) and overall survival (OS) were analysed by the Kaplan–Meier method. Associations between potential predictive markers and survival endpoints were probed by Cox proportional hazards. Results Forty-five patients were included in the analysis. Median age was 63 years, 73% were males and 18% had an ECOG performance status (PS) ≥ 2. ICIs were given as second-line treatment in 60%. Twenty-four patients (53%) received ipilimumab with nivolumab. Twenty-eight patients (62%) had undergone irradiation (RT) prior to or during ICI. Overall response rate (ORR) was 29% and median PFS and OS were 2.3 and 6.5 months, respectively. Median duration of response was 9 months (95% CI 2.8–NA). Five patients maintained their response for > 6 months, all of them receiving combination treatment. There were no new safety signals. Conclusion This is the first report of “real-world” data on ICI in relapsed SCLC also including patients with poor PS. Promising durable responses were observed. No biological prognostic marker could be identified.