The results of adding immunotherapy to chemotherapy in patients with small cell lung cancer: Registurk-Lung study—Real-world data.
Authors: Cil Timucin , Hacibekiroglu Ilhan , Uncu Dogan , Isikdogan Abdurrahman , Ates Ozturk , Sendur Mehmet Ali Nahit , Bilici Mehmet , Geredeli Caglayan , Turk Haci Mehmet , Cicin Irfan , Gumus Mahmut , Bilir Cemil , Ozcelik Melike , Coban Ezgi , Kilickap Sadettin , Demirag Guzin , Yildirim Nilgun , Ozdemir Feyyaz , Teker Fatih , Altinbas Mustafa 
Published: June 2024

e20006 Background: Evaluation of real-world data together with data in clinical studies is very important in the evaluation of treatment algorithms. In real life, treatments are applied to the elderly, patients with poor performance and unusual groups with comorbidities. Determining these treatment results is important in the creation of treatment algorithms. The studies on the addition of immunotherapeutic agents to the standard chemotherapy regimen in patients with small cell lung cancer have found a significant survival advantage. In this study, we evaluated the real-life reflections of the results of these clinical trials. Methods: In our country, within the scope of the Registurk-Lung observational study (NCT05254119), a total of 1008 patients with extensive stage small cell lung cancer were evaluated between December 2021 and December 2023 in 42 centers representing the whole country. The demographic, histopathological, molecular and clinical data of the patients were recorded. The relationship between progression-free survival (PFS) time and overall survival (OS) time with these characteristics was investigated. Results: The median age was 64 (31-88) years and 17.6% of the patients were female. The proportion of patients who never smoked was only 4.7 %. Histopathologically, 36.4% of the patients were diagnosed with squamous cell carcinoma. At the time of diagnosis, brain metastases were present in 13.9 % of the patients and liver metastases were present in 12.1% of the patients. Only 19.4 percent of patients received chemoimmunotherapy. Eighty-three percent of the patients received atezolizumab as immunotherapy in combination with chemotherapy and as maintenance treatment. The other patients received durvalumab and pembrolizumab.Patients who did not receive immunotherapy received platinum plus etoposide chemotherapy regimen as a medyan 4 cycle. The overall response rate was 49.0 % in the chemotherapy group and 52.8 % in the combination group. The PFS was 7.6 (95% CI: 6.9-8.3) months in chemoimmunotherapy group and 7.3 (95% CI: 6.5-8.1) months in chemotherapy group. Also, the OS was 15.5 months (95% CI: 11.1-19.9) in chemoimmunotherapy group and 11.8 (95% CI: 10.5-13.2) months in chemotherapy group. When the two groups were compared, there was a positive trend in terms of PFS in the immunochemotherapy group, but this difference was not statistically significant (p:0,802). In terms of overall survival, there was a statistically significant improvement in the chemoimmunotherapy group (p:0,049). Conclusions: The addition of immunotherapy to the treatment of patients with small cell lung cancer, which we have been treating with dual combination chemotherapy for many years, has provided a survival benefit. This situation brings with it new hopes for future studies.