International Journal of Hematology and Oncology 2020, Vol 30, Num 3 Page(s): 148-154
Chemo-Immunotherapy with Atezolizumab in Extensive-Stage Small-Cell Lung Cancer; Single-Center Experience

Ahmet Bilgehan SAHIN1, Erdem CUBUKCU1, Birol OCAK1, Adem DELIGONUL1, Turgut KACAN2, Sibel Oyucu ORHAN1, Turkkan EVRENSEL1

1Bursa Uludag University, Faculty of Medicine, Department of Medical Oncology, Bursa, TURKEY
2Bursa Yuksek Ihtisas Training and Research Hospital, Department of Medical Oncology, Bursa, TURKEY

Keywords: Atezolizumab, Chemo-immunotherapy, Radiotherapy, Small cell lung cancer
Chemo-immunotherapy (CIT) with platin, etoposide and monoclonal antibodies targeting the PD-1/PDL-1 pathway has recently improved survival in extensive-stage small-cell lung cancer (SCLC) after decades. We aimed to investigate the efficacy and safety of CIT with atezolizumab in extensive-stage SCLC in chemotherapy naïve patients. Eleven patients who were treated and followed in our center were included in this retrospective observational study. All the patients received carboplatin, etoposide and atezolizumab in the induction phase and atezolizumab in the maintenance phase. The Kaplan–Meier test was used to determine progression-free survival (PFS) and overall survival (OS), and the effects of the sites of metastasis were analyzed using the log-rank test. The median age was 69.9 years, and 81.8% were male. The median number of CIT and total atezolizumab cycles was 4 and 7, respectively. 63.6% received maintenance therapy. Median PFS was 5.2 months (95% CI: 3.4-6.9), and median OS was 11.3 months (95% CI: 1.0-21.5). The overall response rate was 63.6%. There was no significant difference between patients with and without liver metastasis in terms of PFS and OS. We observed toxicity higher than grade 2 in more than half of the patients, and hematological toxicities were prominent. CIT with carboplatin, etoposide and atezolizumab is efficient and safe in extensive-stage SCLC considering the PFS, OS, response rates, 12-month survival rate, and side effects. The progression of liver lesions was remarkable. Cranial and thoracic radiation are issues that should be discussed in the future with data from clinical studies.