Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer

Abdülkadir Koçanoğlu; Oktay Ünsal; İbrahim Karadağ; Fırat Şirvan; Serdar Karakaya

doi:10.19161/etd.1977604

TR EN

Yaygın evre küçük hücreli akciğer kanserinde birinci basamak karboplatin–etoposid–atezolizumab tedavisinin gerçek yaşam sonuçları

Abstract

Amaç: Atezolizumabın platin-etoposid kemoterapisine eklenmesi, yaygın evre küçük hücreli akciğer kanserinde (YE-KHAK) standart birinci basamak tedavi haline gelmiştir. Ancak gerçek yaşam verileri ve prognostik faktörlere ilişkin bilgiler sınırlıdır. Bu çalışmada, birinci basamak karboplatin-etoposid-atezolizumab tedavisinin gerçek yaşam sonuçları ile klinik ve PET/BT kaynaklı prognostik faktörler değerlendirildi. Gereç ve Yöntem: Ocak 2022-Aralık 2025 tarihleri arasında birinci basamak karboplatin, etoposid ve atezolizumab tedavisi alan 59 YE-KHAK hastası retrospektif olarak incelendi. Progresyonsuz sağkalım (PSK) ve genel sağkalım (GSK) Kaplan-Meier yöntemiyle analiz edildi. GSK ile ilişkili prognostik faktörler tek ve çok değişkenli Cox regresyon analizleriyle değerlendirildi. Bulgular: Medyan PSK 6,1 ay (%95 GA, 5,6–6,6), medyan GSK ise 8,9 ay (%95 GA, 6,9–10,9) olarak bulundu. ECOG performans skoru (PS) 0–1 olan hastalarda hem PSK (6,3 vs. 4,9 ay; p=0,001) hem de GSK (13,9 vs. 6,5 ay; p=0,002), ECOG PS 2–3 olan hastalara göre anlamlı olarak daha uzundu. Çok değişkenli analizde ECOG PS, GSK için bağımsız prognostik faktör olarak saptandı (HR 2,104; %95 GA 1,183–3,741; p=0,016). Beyin, karaciğer ve kemik metastazları, profilaktik kraniyal ışınlama durumu ile PET/BT'den elde edilen nodal ve metastatik SUVmax değerleri sağkalımla ilişkili bulunmadı. Sonuç: Gerçek yaşam verilerine dayanan bu çalışmada, birinci basamak karboplatin-etoposid-atezolizumab tedavisi alan YE-KHAK hastalarında genel sağkalımı öngören tek bağımsız prognostik faktör ECOG performans skoru olmuştur. PET/BT metabolik parametrelerinin prognostik katkı sağlamaması, kemoimmünoterapi döneminde klinik değerlendirmenin önemini koruduğunu göstermektedir.

Keywords

Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer

Abstract

Aim: The addition of atezolizumab to platinum-etoposide chemotherapy has become the standard first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC). However, real-world data regarding treatment outcomes and prognostic factors remain limited. This study evaluated the effectiveness of first-line carboplatin-etoposide-atezolizumab and investigated clinical and PET/CT-derived prognostic factors in patients with ES-SCLC. Materials and Methods: We retrospectively analyzed 59 consecutive patients with ES-SCLC who received first-line carboplatin, etoposide, and atezolizumab between January 2022 and December 2025. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Prognostic factors for OS were evaluated using univariate and multivariable Cox proportional hazards regression analyses. Results: The median PFS and OS were 6.1 months (95% CI, 5.6–6.6) and 8.9 months (95% CI, 6.9–10.9), respectively. Patients with ECOG performance status (PS) 0–1 had significantly longer PFS (6.3 vs. 4.9 months, p=0.001) and OS (13.9 vs. 6.5 months, p=0.002) than those with ECOG PS 2–3. In multivariable analysis, ECOG PS remained the only independent prognostic factor for OS (HR 2.104, 95% CI 1.183–3.741; p=0.016). Brain, liver, and bone metastases, prophylactic cranial irradiation status, and PET/CT-derived nodal and metastatic SUVmax values were not significantly associated with survival. Conclusions: In this real-world cohort of patients with ES-SCLC treated with first-line carboplatin-etoposide-atezolizumab, ECOG performance status was the only independent prognostic factor for overall survival. PET/CT-derived metabolic parameters did not demonstrate prognostic value, emphasizing the continued importance of simple clinical assessment in the chemoimmunotherapy era.

Keywords

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Details

Primary Language

English

Subjects

Clinical Oncology

Journal Section

Research Article

Authors

Abdülkadir Koçanoğlu
0000-0002-5579-2135
Türkiye

Oktay Ünsal
0000-0002-3215-8457
Türkiye

İbrahim Karadağ
0000-0002-2356-6790
Türkiye

Fırat Şirvan ^*
0009-0004-8210-0837
Türkiye

Serdar Karakaya
0000-0002-2111-7131
Türkiye

Publication Date

September 3, 2026

Submission Date

June 23, 2026

Acceptance Date

July 28, 2026

Published in Issue

Year 2026 Volume: 65 Number: 3

DOI

https://doi.org/10.19161/etd.1977604

IZ

https://izlik.org/JA77PG62UG

Cite

RIS / Bibtex

APA

Koçanoğlu, A., Ünsal, O., Karadağ, İ., Şirvan, F., & Karakaya, S. (2026). Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer. Ege Tıp Dergisi, 65(3), 572-580. https://doi.org/10.19161/etd.1977604

AMA

1.Koçanoğlu A, Ünsal O, Karadağ İ, Şirvan F, Karakaya S. Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer. EJM. 2026;65(3):572-580. doi:10.19161/etd.1977604

Chicago

Koçanoğlu, Abdülkadir, Oktay Ünsal, İbrahim Karadağ, Fırat Şirvan, and Serdar Karakaya. 2026. “Real-World Outcomes of First-Line Carboplatin–etoposide–atezolizumab in Extensive-Stage Small-Cell Lung Cancer”. Ege Tıp Dergisi 65 (3): 572-80. https://doi.org/10.19161/etd.1977604.

EndNote

Koçanoğlu A, Ünsal O, Karadağ İ, Şirvan F, Karakaya S (September 1, 2026) Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer. Ege Tıp Dergisi 65 3 572–580.

IEEE

[1]A. Koçanoğlu, O. Ünsal, İ. Karadağ, F. Şirvan, and S. Karakaya, “Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer”, EJM, vol. 65, no. 3, pp. 572–580, Sept. 2026, doi: 10.19161/etd.1977604.

ISNAD

Koçanoğlu, Abdülkadir - Ünsal, Oktay - Karadağ, İbrahim - Şirvan, Fırat - Karakaya, Serdar. “Real-World Outcomes of First-Line Carboplatin–etoposide–atezolizumab in Extensive-Stage Small-Cell Lung Cancer”. Ege Tıp Dergisi 65/3 (September 1, 2026): 572-580. https://doi.org/10.19161/etd.1977604.

JAMA

1.Koçanoğlu A, Ünsal O, Karadağ İ, Şirvan F, Karakaya S. Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer. EJM. 2026;65:572–580.

MLA

Koçanoğlu, Abdülkadir, et al. “Real-World Outcomes of First-Line Carboplatin–etoposide–atezolizumab in Extensive-Stage Small-Cell Lung Cancer”. Ege Tıp Dergisi, vol. 65, no. 3, Sept. 2026, pp. 572-80, doi:10.19161/etd.1977604.

Vancouver

1.Abdülkadir Koçanoğlu, Oktay Ünsal, İbrahim Karadağ, Fırat Şirvan, Serdar Karakaya. Real-world outcomes of first-line carboplatin–etoposide–atezolizumab in extensive-stage small-cell lung cancer. EJM. 2026 Sep. 1;65(3):572-80. doi:10.19161/etd.1977604