Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

A retrospective review of small cell lung cancer in a regional centre in Victoria     (#366)

Bridget Josephs 1 , Cassie Moore 1 , Ash de Silva 2 , Tricia Wright 1 , Mahesh Iddawela 1 3 , Evangeline Samuel 1 4
  1. Latrobe Regional Hospital, Traralgon, VIC, Australia
  2. Pharmacy, Gippsland Health Alliance, Traralgon, VIC, Australia
  3. Central Clinical School & Department of Rural Health, Monash University, Melbourne, VIC, Australia
  4. School of Public Health and Preventive Medicine, Monash University , Melbourne, VIC, Australia

Aim:

To describe patient and disease characteristics, patterns of care and real-world outcomes in small cell lung cancer (SCLC) in a single regional centre.

 

Methods:

Retrospective audit of all Medical Oncology inpatients and outpatients diagnosed with SCLC between January 1, 2020 to June 30, 2023.

 

Results:

During 1/01/2020 to 30/06/2023, 76 patients were diagnosed with SCLC. 60% were male(n=45) and 4%(n=3) were Indigenous Australian. Median age at diagnosis: 66(range 40-82 years). All had a current or prior smoking history. Most patients had extensive-stage (ES) disease (n=60,79%). Limited-stage (LS) SCLC (n=16,21%) comprised the remainder. Hyponatremia was present in 25% at diagnosis(n=19). ECOG performance status at presentation included: 0 (n=12,16%), 1-2 (n=46,61%), 3 (n=4,5%), not documented(n=14,18%). Of those with ES-SCLC, brain and liver metastases were present in 18%(n=11) and 47%(n=29) patients at diagnosis respectively.

FDG-PET was utilised for staging in n=50 patients(66%), including 15 of 16 patients with LS-SCLC. Brain staging was most frequently performed with a CT (CT-brain alone: n=49,(65%); MRI-brain alone: n=9,(12%); both modalities: n=14,(18%). 

Seventy-two patients (95%) received active treatment. Median time from biopsy to first treatment was 9 days (interquartile range(IQR) 6-19 days).By subgroup: 14 days(IQR 9-25) for LS-SCLC, 8 days(IQR 6-15) for ES-SCLC patients.

MRI-brain surveillance, rather than prophylactic cranial irradiation (PCI), was more frequent in patients with LS-SCLC following completion of definitive treatment(n=1 received PCI).

At time of analysis, eight(50%) patients with LS-SCLC had relapsed. Of forty-four ES-SCLC patients that received first-line carboplatin, etoposide and atezolizumab, survival ranged from 13 days to alive at 25 months and fourteen(32%) and two(5%) patients had survived ≥12 and ≥24 months respectively. Fourteen(23%) patients with ES-SCLC received ≥2 lines systemic treatment.

38%(n=29) of the cohort had brain metastases during their disease course.

 

Conclusion:

We report on SCLC in a regional setting. In identifying opportunities to improve patient care, reviewing supportive and palliative care referral practice would also be useful.