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Even for patients with limited-stage small cell lung cancer (LS-SCLC) who have completed cCRT

SUCCESS MAY BE FLEETING

While cCRT is the standard of care, patients are at the highest risk of progression within 2 years following cCRT completion. Treatment advances that improve patient outcomes are urgently needed.1,2

LS-SCLC, an aggressive disease – read more
LS-SCLC defined

LS-SCLC is an aggressive disease with a high rate of progression2,3

SCLC is characterized by a rapid doubling time and tendency for early and widespread metastases4

Survival outcomes remain poor for the majority of patients with LS-SCLC5

5-year overall survival rate for LS-SCLC5*

 

15.6%

of all patients irrespective of treatment

Every patient deserves the most effective guideline-recommended treatments currently available

*These data are based on a 2023 study analyzing clinical data from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019) of patients with primary lung cancer (n=847,747), of which 13.1% had SCLC (n=111,263). Among patients with LS-SCLC, the 5-year overall survival rate was 15.6% in 2014.5

cCRT=concurrent chemoradiotherapy; LS-SCLC=limited-stage small cell lung cancer; SCLC=small cell lung cancer.

cCRT, guideline-recommended treatment – read more
CONVERT study—cCRT

In the curative intent setting of LS-SCLC, cCRT is a guideline-recommended treatment option4*†

Initially, LS-SCLC is highly responsive to both chemotherapy and radiotherapy4

  • In a secondary analysis of the CONVERT study (n=509), disease control was achieved in up to 77% of patients who had completed 4 to 6 cycles of cCRT6‡§
  • NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend platinum-based cCRT for patients with unresectable LS-SCLC (ECOG PS 0-2)4†

5-year overall survival rate for LS-SCLC in the CONVERT study2‖¶

 

Up to

34%

of patients when treated with cCRT‖#

However,

most patients will progress within the highest-risk period of 2 years following cCRT2,6

The CONVERT study: Patterns of progression in patients with LS-SCLC following cCRT6¶#

Secondary analysis based on CONVERT study data CONVERT study graphic CONVERT study graphic

*In certain patients with Stage I to IIA SCLC, surgery is recommended. Only about 5% of patients are eligible for surgery.4

†NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

‡The CONVERT study was an open-label, multicenter, Phase III trial conducted between April 2008 and November 2013. 547 adult patients (aged ≥18 years) with LS-SCLC were randomized to receive once-daily cCRT (n=273) or twice-daily cCRT (n=274). The median follow-up in the primary analysis was 45 months (IQR 35-58). The primary endpoint of the study was overall survival, defined as time from randomization until death from any cause. A secondary analysis of the CONVERT study (n=509) was conducted to compare outcomes between patients with TNM Stage I to II (n=86) and those with Stage III (n=423) SCLC. This post-hoc analysis was performed from November 2017 to February 2018.2,6,7

§76% of patients with Stage I to II disease (95% CI, 66%-83%) and 77% of patients with Stage III disease (95% CI, 73%-81%) achieved disease control (complete or partial response on any follow-up CT).6

∥5-year overall survival was 34% (95% CI, 27.0-41.0) in the group given twice-daily cCRT and 31% (95% CI, 25.0-37.0) in the group given once-daily cCRT (absolute difference=2.8%; 95% CI, -6.4-12.0).2

25 (9%) of 273 patients in the twice-daily radiotherapy group and 33 (12%) of 270 patients in the once-daily radiotherapy group did not receive cCRT.2

#These data represent patients who were randomly assigned 1:1 to receive concurrent once-daily or twice-daily radiotherapy.6

cCRT=concurrent chemoradiotherapy; CI=confidence interval; CT=computed tomography; ECOG=Eastern Cooperative Oncology Group; IQR=interquartile range; LS-SCLC=limited-stage small cell lung cancer; NCCN=National Comprehensive Cancer Network® (NCCN®); PS=performance status; SCLC=small cell lung cancer; TNM=tumor, node, metastasis.

Multidisciplinary coordination – read more
Multidisciplinary coordination

Multidisciplinary team (MDT) coordination may enable more effective implementation of cCRT8

MDT coordination helps provide patients with LS-SCLC guideline-recommended treatment8

These healthcare providers may play key roles in developing treatment plans for patients with SCLC9

Medical Oncologist

Radiation Oncologist

Pulmonologist

Surgeon

Nurse

Percentage of patients who received NCCN Guidelines®-recommended treatment8,10*

 

81%

without MDT review

vs
 

97%

with MDT review

In a retrospective study of patients with carcinoma of the lung or bronchus, nearly all patients received NCCN Guideline-recommended treatment after multidisciplinary review.†

MDT coordination is essential to integrating guideline-recommended treatment options8

Open communication among oncology specialties is imperative for discussing latest treatment advances in LS-SCLC and optimal treatment strategies.8

AstraZeneca is committed to improving the lives of patients with LS-SCLC

*NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

†These data are based on a retrospective analysis of patients with carcinoma of the lung or bronchus at a tertiary care medical center between January 2001 and December 2007.10

cCRT=concurrent chemoradiotherapy; LS-SCLC=limited-stage small cell lung cancer; NCCN=National Comprehensive Cancer Network® (NCCN®); SCLC=small cell lung cancer.

References: 1. Khurshid H, Ismaila N, Bian J, et al. Systemic therapy for small-cell lung cancer: ASCO-Ontario Health (Cancer Care Ontario) guideline. J Clin Oncol. 2023;41(35):5448-5472. 2. Faivre-Finn C, Snee M, Ashcroft L, et al. Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial. Lancet Oncol. 2017;18(8):1116-1125. 3. Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol. 2017;14(9):549-561. 4. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2024. ©National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed November 28, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org. 5. Cohen S, Brennan B, Banerjee M, Kalemkerian GP. Temporal trends in small cell lung cancer: analysis of the U.S. Surveillance, Epidemiology and End Results (SEER) database. J Clin Oncol. 2023;41(suppl 16):e20641-e20641. 6. Salem A, Mistry H, Hatton M, et al. Association of chemoradiotherapy with outcomes among patients with stage I to II vs stage III small cell lung cancer: secondary analysis of a randomized clinical trial. JAMA Oncol. 2019;5(3):e185335. 7. Faivre-Finn C, Falk S, Ashcroft L, et al. Protocol for the CONVERT trial—Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status. BMJ Open. 2016;6(1):e009849. 8. Heinke MY, Vinod SK. A review on the impact of lung cancer multidisciplinary care on patient outcomes. Transl Lung Cancer Res. 2020;9(4):1639-1653. 9. Ledezma B. Multidisciplinary care teams and patient centricity in small cell lung cancer. AstraZeneca. Published July 19, 2021. Accessed June 6, 2024. https://www.astrazeneca-us.com/media/astrazeneca-us-blog/2021/multidisciplinary-care-teams-and-patient-centricity-in-small-cell-lung-cancer-07192021.html#. 10. Freeman RK, Van Woerkom JM, Vyverberg A, Ascioti AJ. The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer. Eur J Cardiothorac Surg. 2010;38(1):1-5.

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