A cross-sectional analysis of treatment patterns in small-cell lung cancer in five European countries
Creators: name: Reguart, Noemi
name: Pérol, Maurice
name: Cortinovis, Diego
name: Puntis, Stephen
name: Öhrling, Katarina
name: Archangelidi, Olia
name: Louie, Karly S
name: Blackhall, Fiona
name: Sebastian, Martin
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Cell Biology
subject: Pharmacology
subject: Ecology
subject: FOS: Biological sciences
subject: Immunology
subject: FOS: Clinical medicine
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Plant Biology

description: <b>Aim:</b> To investigate changes in treatment patterns in extensive-stage small-cell lung cancer (ES-SCLC) in France, Germany, Italy, Spain and the UK (EU5) between 2018 and 2021. <b>Methods:</b> Cross-sectional data from an oncology database were analyzed retrospectively. <b>Results:</b> Of 5832 eligible patients, 88.4% had stage IV disease at diagnosis. Among patients receiving first-line treatment, 91.8% (1079 /1176) received the platinum-etoposide (PE) combination in 2018 which decreased to 42.3% (509/1203) by 2021. Usage of the PE-atezolizumab combination increased from 0 to 41.2% during the same timeframe. Topotecan monotherapy remained the most widely used second-line treatment regardless of patients' platinum sensitivity. <b>Conclusion:</b> The first-line standard of care for ES-SCLC has evolved in EU5 with the PE-atezolizumab/durvalumab combination gradually superseding PE usage. Lung cancer is the leading cause of cancer-related deaths. Small-cell lung cancer (SCLC) is fast-growing type of lung cancer. New treatments for SCLC using medicines that stimulate the immune system to kill cancer cells (called immunotherapies) have recently been approved for use in Europe. The purpose of the study was to describe the type of treatments that patients received in five European countries before and after the introduction of these new treatments to determine how quickly these new treatments were adopted in a real-world setting. This study found that most patients treated between 2018 and 2020 still received a platinum-based chemotherapy as their first anticancer therapy, but immunotherapies were used more often in later years and became the most common first treatment in 2021 for patients who had never been treated for their cancer. Topotecan, a type of chemotherapy, was the most used treatment for patients whose cancer came back after treatment. There is still a clear unmet need for new, safe and effective therapies for the treatment of patients with SCLC whose cancer comes back again after treatment. Real-world data from 5,832 patients with extensive-stage small-cell lung cancer (ES-SCLC) who were treated in France, Germany, Italy, Spain and the UK (EU5) between 2018 and 2021 were analyzed to identify patient characteristics and changes in treatment patterns following the approval of atezolizumab and durvalumab in combination with platinum-etoposide chemotherapy for first-line treatment of ES-SCLC in Europe. Atezolizumab with platinum-etoposide chemotherapy was rapidly adopted as first-line treatment in France, Germany and the UK while the adoption was relatively slower in Italy and Spain. The country-specific differences in the adoption of immunotherapy were potentially related to the different time points at which reimbursement for anti-PD-L1 immunotherapy was initiated in these countries. Topotecan remained the most widely used second-line treatment for patients regardless of platinum sensitivity or the duration of the platinum-free interval after first-line therapy (3–6 months vs ≥6 months). This study highlights the presence of an unmet need for newer treatment options for ES-SCLC in the second-line and beyond.