Treatment patterns and clinical outcomes in real-world patients with small-cell lung cancer in South Korea: A single-center experience.

We examined treatment patterns and overall survival (OS) among patients with small-cell lung cancer (SCLC) in South Korea. This retrospective cohort study included patients with SCLC treated at Samsung Medical Center between January 1, 2018 and December 31, 2021, with follow-up through March 13, 2023. The first systemic therapy after initial diagnosis was defined as first-line, with subsequent lines identified by initiation of new regimens. Survival outcomes were estimated from the start of each treatment line. Among 515 patients, 343 had extensive-stage (ES) and 172 had limited-stage (LS) at diagnosis. Platinum-based regimen without anti-PD-L1 was the most common first-line regimen for both groups; however, use of anti-PD-L1 containing platinum regimens increased markedly from 2020 onward in patients with ES-SCLC. In the second line setting, 64% of patients with ES-SCLC received platinum-based therapy and 31% irinotecan monotherapy, whereas taxanes were predominantly used in patients with LS-SCLC (51.7%). Median OS for ES-SCLC following first-line treatment was 11.3 months (95% CI: 9.7, 12.2) [11.4 months (95% CI: 9.6, 12.8) with anti-PD-L1 vs. 11.1 months (95% CI: 9.2, 12.5) without], and 29.8 months (95% CI: 23.6, 46.6) months following first definitive therapy for LS-SCLC. Median OS declined to 6.9 months (95% CI: 6.3, 7.9) after second line therapy in ES-SCLC and 12.1 months (95% CI: 7.9, 17.1) in patients with LS-SCLC following 1L therapy after initial definitive therapy. These findings characterize the evolving SCLC treatment landscape, underscore the limited effectiveness of current treatment options, and highlight the persistent poor prognosis in this population.