Real-world effectiveness and safety of atezolizumab-carboplatin-etoposide regimen in extensive-stage small-cell lung cancer.

[OBJECTIVE] The objective is to describe the real-world effectiveness and safety of atezolizumab in combination with carboplatin and etoposide as first-line treatment for patients with extensive-stage small-cell lung cancer.

[METHODS] We conducted a retrospective observational study of 48 patients with extensive-stage small-cell lung cancer treated with atezolizumab, carboplatin, and etoposide between March 2022 and May 2024 at a tertiary care center. The primary endpoints were progression-free survival and overall survival, analyzed using the Kaplan-Meier method. Safety outcomes and clinical predictors of survival were also assessed using software SPSS v26.

[RESULTS] After a median follow-up of 7.6 months (range: 1.5-28.4), median progression-free survival was 5.8 months and median overall survival was 7.1 months. Baseline ECOG performance status (ECOG 1 and 2) and the presence of brain metastases were associated with reduced overall survival. Patients who received ≤2 cycles of maintenance atezolizumab showed inferior survival outcomes. Grade 3-4 treatment-related adverse events occurred in 60.4% (n = 29) of patients, with hematologic toxicity being the most frequent.

[CONCLUSIONS] In this real-world cohort, atezolizumab in combination with carboplatin and etoposide demonstrated feasibility and a manageable safety profile in first-line treatment of extensive-stage small-cell lung cancer. Longer follow-up and larger sample sizes are warranted to confirm these findings and further define prognostic markers in clinical practice.