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

Area of Science:

• Oncology
• Immunotherapy
• Lung Cancer Research

Background:

• Early clinical trials indicated potential efficacy of immune-checkpoint inhibitors (ICI) for a subset of patients with relapsed small-cell lung carcinoma (SCLC).
• Real-world data are crucial for understanding ICI effectiveness and safety in diverse patient populations, including those with less favorable prognostic factors.

Purpose of the Study:

• To evaluate the real-world efficacy and safety of immune-checkpoint inhibitors (ICI) in patients with relapsed small-cell lung carcinoma (SCLC).
• To assess survival outcomes and response rates in a broader patient cohort treated in routine clinical practice.

Main Methods:

• A retrospective analysis was conducted across nine Swiss cancer centers.
• Data included patient demographics, treatment details (ICI type, line of therapy, prior radiation), and response assessments (RECIST v1.1).
• Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier methods; Cox proportional hazards models explored predictive markers.

Main Results:

• The cohort comprised 45 patients with relapsed SCLC, with a median age of 63 years and 18% having ECOG performance status ≥2.
• The overall response rate (ORR) was 29%, with a median PFS of 2.3 months and median OS of 6.5 months.
• Combination ipilimumab and nivolumab treatment and prior radiation were noted; five patients achieved durable responses (>6 months), all on combination therapy. No new safety concerns were identified.

Conclusions:

• This study provides the first real-world data on ICI for relapsed SCLC, including patients with poor performance status.
• Promising durable responses were observed, suggesting ICI utility in this setting.
• No specific biological prognostic marker for ICI response was identified in this cohort.