Treatment of extensive stage small cell lung cancer (ES-SCLC) in geriatric patients before the advent of immunotherapy: Real-life experience from one centre.

person Soledad Medina Hospital de León, León, Spain info_outline Soledad Medina, Paola Gudiel Arriaza, Angel Rodriguez, Mariana Lopez, Ana López González, Beatriz Nieto Mangudo, Manuela Pedraza, Carmen Castañon, Luis De Sande González, Juan Ignacio López Fernández, Samuel Sáez Álvarez, Pablo Segovia Alonso, Elvira Fernandez Fernandez, Manuel Fernandez Fernandez, Andrés García Palomo, Pilar Diz

Authors person Soledad Medina Hospital de León, León, Spain info_outline Soledad Medina, Paola Gudiel Arriaza, Angel Rodriguez, Mariana Lopez, Ana López González, Beatriz Nieto Mangudo, Manuela Pedraza, Carmen Castañon, Luis De Sande González, Juan Ignacio López Fernández, Samuel Sáez Álvarez, Pablo Segovia Alonso, Elvira Fernandez Fernandez, Manuel Fernandez Fernandez, Andrés García Palomo, Pilar Diz Organizations Hospital de León, León, Spain, Hospital de León, Leon, Spain, Medical Oncology Department, Complejo Asistencial Universitario de León, León, Spain, Hospital Santisima Trinidad, Salamanca, Spain, University Health Care Complex of Leon, Leon, Spain Abstract Disclosures Research Funding No funding received None. Background: SCLC is an aggressive and difficult-to-treat type of lung cancer that in recent years is increasing in incidence in those over 70 years of age. Moreover, in geriatric patients, treatment of ES-SCLC may be even more difficult due to the lack of prospective data in this more vulnerable population. In this study we will evaluate first-line chemotherapy-based treatment in the elderly. Methods: Retrospective observational trial. Patients over 70 years of age diagnosed with ES-SCLC who were treated at the Hospital Universitario de León between January 2017 and January 2022 were analysed. Data were collected from each patient's electronic medical record. To limit bias, those who had previously received treatment for limited stage or who had undergone combination chemotherapy with immunotherapy were excluded. SPSS Statics was used to analyse treatment response, 1- and 2-year survival rate, overall survival (OS) and progression-free survival (PFS). Results: 22 patients (pat.) met the elegibility criteria. Mean age 75.6 (±3.99 SD), 86.4% male (19 pat.). Eastern Cooperative Oncology Group (ECOG) score: ECOG-0 18% (4 pat.), ECOG-1 59% (13 pat.), ECOG-2 5% (1 pat.), ECOG-3 18% (4 pat.). At diagnosis, 36.4% (8 pat.) were current smokers and 63.6% (14 pat.) were former smokers; 68.2% (15 pat.) were taking more than 5 drugs. The mean Charlson scale score was 11 (±1.7 SD), while the mean Frail scale score was 2.23 (±0.97 SD). All patients received platinum-etoposide chemotherapy, 77.3% (17 pat.) with carboplatin-etoposide, 22.7% (5 pat.) with cisplatin-etoposide and of the total. There were only 6 patients with reduced starting doses and of the total patients, 54.5% (12 pat.) completed 6 cycles; 18.2% (4 pat.) 5 cycles and 27.3% (6 pat.) 2 cycles or less. Response was evaluable in 18 patients: 15 had partial response, 1 had stable disease and 2 had progression disease. At the time of analysis, there had been 21 deaths. Median OS was 10 months (95% CI 5,4-14,6) and median PFS was 6 months (95% CI 4,2-7,8). The 1-year survival rate was 45% and the 2-year survival rate was 9%. Conclusions: Despite the small number of patients, our data are similar to those obtained in the control arms of immunotherapy trials. A larger sample would be needed to consolidate our results and we plan to extend the study to other hospitals. Nevertheless, these results suggest elderly patients may benefit from treatment procedures applied in younger populations.