Synchronous Oligometastasis and Oligoprogression as a Prognostic Marker in Patients With Extensive-Stage SCLC Treated With a Combination of Immune-Checkpoint Inhibitor and Chemotherapy (HOT2301)

Kana Hashimoto; Daisuke Morinaga; Hajime Asahina; Mina Ishidoya; Hajime Kikuchi; Hiroshi Yokouchi; Toshiyuki Harada; Osamu Honjo; Ryota Shigaki; Taichi Takashina; Yuka Fujita; Mamoru Takahashi; Yasutaka Kawai; Ryotaro Kida; Kenichiro Ito; Noriaki Sukoh; Ayumu Takahashi; Fumihiro Hommura; Yoshihito Ohhara; Megumi Furuta; Satoshi Konno; Yukio Hosomi; Satoshi Oizumi; Hokkaido Lung Cancer Clinical Study Group Trial

doi:10.1016/j.jtocrr.2024.100715

Synchronous Oligometastasis and Oligoprogression as a Prognostic Marker in Patients With Extensive-Stage SCLC Treated With a Combination of Immune-Checkpoint Inhibitor and Chemotherapy (HOT2301)

JTO Clin Res Rep. 2024 Sep 7;5(11):100715. doi: 10.1016/j.jtocrr.2024.100715. eCollection 2024 Nov.

Authors

Kana Hashimoto¹, Daisuke Morinaga², Hajime Asahina³, Mina Ishidoya^{4

5}, Hajime Kikuchi⁶, Hiroshi Yokouchi³, Toshiyuki Harada⁷, Osamu Honjo⁸, Ryota Shigaki⁹, Taichi Takashina¹⁰, Yuka Fujita¹¹, Mamoru Takahashi¹², Yasutaka Kawai¹³, Ryotaro Kida¹⁴, Kenichiro Ito¹⁵, Noriaki Sukoh¹⁶, Ayumu Takahashi¹⁷, Fumihiro Hommura¹⁸, Yoshihito Ohhara¹⁹, Megumi Furuta², Satoshi Konno², Yukio Hosomi¹, Satoshi Oizumi³; Hokkaido Lung Cancer Clinical Study Group Trial

Affiliations

¹ Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
² Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
³ Department of Respiratory Medicine, NHO Hokkaido Cancer Center, Sapporo, Japan.
⁴ Department of Respiratory Medicine, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan.
⁵ Department of Respiratory Medicine, Aomori Prefectural Central Hospital, Aomori, Japan.
⁶ Department of Respiratory Medicine, Obihiro-Kosei General Hospital, Obihiro, Japan.
⁷ Department of Respiratory Medicine, JCHO Hokkaido Hospital, Sapporo, Japan.
⁸ Department of Respiratory Medicine, Sapporo Minami-Sanjo Hospital, Sapporo, Japan.
⁹ Department of Internal Medicine, Division of Respiratory Medicine and Neurology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
¹⁰ Department of Respiratory Medicine, Iwamizawa Municipal General Hospital, Iwamizawa, Japan.
¹¹ Department of Respiratory Medicine, NHO Asahikawa Medical Center, Asahikawa, Japan.
¹² Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan.
¹³ Department of Respiratory Medicine, Oji General Hospital, Tomakomai, Japan.
¹⁴ Department of Respiratory Medicine, Hokkaido Prefectural Kitami Hospital, Kitami, Japan.
¹⁵ Department of Respiratory Medicine, KKR Sapporo Medical Center, Sapporo, Japan.
¹⁶ Department of Respiratory Medicine, NHO Hokkaido Medical Center, Sapporo, Japan.
¹⁷ Department of Medicine, Hokkaido Chuo Rosai Hospital, Japan Organization of Occupational Health and Safety, Iwamizawa, Japan.
¹⁸ Department of Respiratory Medicine, Sapporo City General Hospital, Sapporo, Japan.
¹⁹ Department of Medical Oncology, Hokkaido University Hospital, Hokkaido, Japan.

Abstract

Introduction: Oligometastasis and oligoprogression (OP) has not been adequately defined in extensive-stage SCLC (ES-SCLC) and may be a good indication for adding local treatment. Therefore, this multicenter study aimed to investigate the prognostic impact of oligometastasis and OP in ES-SCLC.

Methods: We enrolled patients who received chemoimmunotherapy between September 2019 and June 2022. Patients were classified into oligometastasis and non-oligometastasis groups by determining the number of original tumor lesions and distant metastases (worsening or newly appearing lesions) at the time of initial diagnosis and disease progression after first-line treatment.

Results: We retrospectively analyzed 265 consecutive patients with ES-SCLC. Synchronous oligometastasis (SOM) and OP was defined as less than or equal to five lesions in less than or equal to two organs, including lungs; 21.0% and 53.2% of patients had SOM and OP, respectively. Median progression-free survival was 5.8 months and 4.9 months in patients with and without SOM, respectively (hazard ratio [HR] = 0.72, 95% confidence interval [CI]: 0.51-1.02, p = 0.065). Median overall survival was 20.5 months and 15.0 months in patients with and without SOM (HR = 0.58, 95% CI: 0.37-0.95, p = 0.027) from the initiation of first-line treatment. The OP group revealed a better progression-free survival of 5.2 months (versus 3.2 mo, HR = 0.69, 95% CI: 0.50-0.96, p = 0.026) and overall survival of 15.1 months (versus 7.5 mo, HR = 0.44, 95% CI: 0.29-0.66, p = 0.027) from the initiation of second-line treatment compared with the non-OP group. The Lung Immune Prognostic Index score was significantly lower in the SOM and OP group.

Conclusions: ES-SCLC in patients with SOM and OP may be more indolent than that of the nonoligometastasis group, therefore, new treatment strategies, including the addition of local treatment, should be explored.

Clinical trial registration: This study was registered at UMIN-CTR (UMIN000053402).

Keywords: Extensive-stage small cell lung cancer; Immune-checkpoint inhibitor; Oligoprogression; Synchronous oligometastasis.