Clinical outcomes of local treatments for oligoprogressive or oligorecurrent small cell lung cancer.

Abstract

8090 Background: The role of local treatments in patients with oligoprogressive or oligorecurrent small cell lung cancer (SCLC) remains unclear. Our study aimed to describe the prognosis of patients with SCLC receiving a local treatment for oligoprogression or oligorecurrence in a real-life setting. Methods: The present study included all consecutive patients treated for SCLC at Lille University Hospital or Strasbourg University Hospital between January 2013 and March 2024, for whom local treatment was decided in a Multidisciplinary Tumor Board to control oligoprogression or oligorecurrence. Clinical data and characteristics of the local treatment were collected from medical records. Results: Of the 850 patients treated for a SCLC in both centers during the study period, 97 patients were eligible for inclusion. Of those, 84 received local treatment for oligoprogression (n = 47) or oligorecurrence (n = 37). At the time of oligoprogression or oligorecurrence, 82.1% of patients were being treated for extensive-stage disease. The brain was the predominant site of oligoprogression or oligorecurrence (71%) and the most commonly used local treatment was conformal radiotherapy (66.7%), followed by stereotactic radiotherapy (31%) and surgery (2.4%). Grade ≥3 adverse events were observed in only 2.4% of treated patients. After a median follow-up period of 11.9 months, the median overall survival (OS) and median progression-free survival (PFS), measured from the date of initiation of local treatment, were 12.4 months (95% CI: 10.7-18.9), and 3.4 months (95 %CI: 2.4-4.5), respectively. A good performance status (PS 0–1) was associated with better OS (HR 0.50; (95% CI: 0.26–0.97); p = 0.018). PFS was significantly longer in patients with limited-stage SCLC (HR 0.52; (95% CI: 0.31–0.89); p = 0.016) or with five or fewer metastases at the time of local treatment (HR 0.59; (95% CI: 0.37–0.94); p = 0.038). Most progressions observed after local treatment occurred distant from the treated sites (68.8%). Conclusions: This study demonstrates that the use of local treatments to control oligoprogression or oligorecurrence in SCLC is not uncommon in routine clinical practice. While this strategy is generally well tolerated, its efficacy remains limited. Further studies are needed to clarify its role in the era of tarlatamab development.