Small cell lung cancer (SCLC) is an aggressive tumor with early metastasis and a low 5-year survival rate (6.4%). Despite the use of PD-L1 inhibitors (atezolizumab, durvalumab) in combination with chemotherapy, outcomes remain unsatisfactory due to resistance and patient heterogeneity. Objective. To evaluate the effectiveness of immunochemotherapy (atezolizumab+carboplatin/etoposide) in real-world clinical practice in patients with metastatic SCLC. Material and methods. Data from 98 patients (87 men, 11 women, median age 62 years) over 50 months (2020—2024) were analyzed. Treatment regimen: carboplatin (AUC5), etoposide (100 mg/m²), and atezolizumab (1200 mg) every 3 weeks (4 cycles), followed by maintenance therapy. Progression-free survival (PFS), overall survival (OS), and the impact of metastases/comorbidities were assessed. Results. Median PFS was 6 months, OS was 12 months. Partial response was observed in 60.2%, stable disease in 23.5%, disease progression in 13.3%, and complete response in 3.1%. Metastases in the liver, bones, peritoneum, and kidneys significantly reduced PFS and OS (p< 0.05). Comorbidities had no significant impact. Conclusion. The combination of atezolizumab with chemotherapy demonstrates efficacy comparable to clinical trial data, but outcomes depend on metastasis location. Metastatic involvement of the liver, bones, and peritoneum is associated with a worse prognosis, highlighting the need for personalized treatment approaches.
Султанбаев et al. (Tue,) studied this question.