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The following is a summary of “Real-life nationwide characteristics and outcomes of small cell lung cancer over the last 20 years: impact of immunotherapy on overall survival in a real-life setting,” published in the August 2024 issue of Oncology by Falchero et al.

The KBP studies represent a series of nationwide, prospective, multicenter cohort investigations conducted across French non-academic public hospitals, focusing on patients diagnosed with primary lung cancer. This study synthesizes data from these cohorts, explicitly examining the characteristics and treatment outcomes of patients with small cell lung cancer (SCLC) in the 2020 cohort and comparing them with previous decades.

They analyzed data from three prospective cohorts using consistent methodologies. This analysis describes and contrasts the patient demographics and clinical outcomes for SCLC, particularly emphasizing treatment modalities employed in 2020.

The 2020 cohort included 8,999 patients with lung cancer, of whom 1,137 had SCLC. The proportion of SCLC cases among all patients with lung cancer declined from 16.4% in 2000 to 13.5% in 2010 and further to 12.6% in 2020. Notably, the percentage of women with SCLC increased significantly from 15.5% in 2000 to 35.7% in 2020. Of the patients with SCLC, 15.4% had limited-stage (LS) disease, while 84.6% presented with extensive-stage (ES) disease. The 1-year overall survival (OS) rate for patients with SCLC improved from 34.4% in 2000 to 38.4% in 2020. For patients with ES-SCLC, multivariate analysis—adjusted using entropy balancing for variables such as age, sex, performance status, number of metastatic sites, and brain metastases—revealed that the median OS increased from 8.1 months with chemotherapy alone to 11.1 months with the addition of immunotherapy (HR 0.62, p<0.001).

While the overall proportion of SCLC cases has decreased over the past two decades, the representation of women with SCLC has risen markedly. The 1-year OS rates for patients with SCLC have shown a positive trend. The data from the KBP-2020 cohort suggest that combining immunotherapy with chemotherapy offers a significant survival advantage for patients with ES-SCLC in a real-world clinical setting.

Source: sciencedirect.com/science/article/abs/pii/S095980492400933X