番茄社区

At the virtual European Society for Medical Oncology (ESMO) meeting, researchers explored the clinical characteristics, treatment patterns, and early outcomes of the addition of atezolizumab (Tecentriq) to chemotherapy in small cell lung cancer (SCLC) -- the IMpower133 regimen -- in the real-world setting.

In this exclusive 番茄社区 video, , of the University of Southern California Norris Comprehensive Cancer Center in Los Angeles, discusses the data presented and the clinical implications.

Following is a transcript of his remarks:

IMpower133 was an important clinical trial that showed the importance of immunotherapy in patients with small cell lung cancer, and in the real-world evidence presented at ESMO this weekend we see that in the real world, the results from the patient population is surprisingly similar to what we saw in the initial clinical trial.

Now of course the patient populations were actually different. The patient population in the real-world evidence study was older, had a lower performance status, and more patients had longer than six cycles of therapy. But they actually had an identical progression-free survival at 5.2 months to what you saw in the original IMpower133 trial.

So I think this is overall great news. This tells us that our findings from clinical trials are applicable to a real-world population, and that what we should expect to happen in the real world is in fact what's happened with clinical trials.

And this is something that we've seen before with the Flatiron-collected data. We had a very similar study that we presented at ASCO this year, showing that the real-world evidence from osimertinib [Tagrisso] was very similar to what was seen in osimertinib's original clinical trials.

So overall I think this is good. The studies are applicable, but I think we're missing an important part of the story. And an important part of the story is that the real-world evidence population was a sicker population. They had a worse performance status. They were older. They should have done worse. And why didn't they?

So I think that there's a number of potential reasons why that may have been the case. It may be that when someone enrolls in a clinical trial, the treatment delays associated with clinical trial enrollment are a negative, and the real-world evidence population didn't see that, but the clinical trial population did.

It's also possible that the performance status data in the IMpower133 trial simply wasn't accurate, and the patients didn't actually have as good a performance status as what was presented by the investigators, since performance status is notoriously difficult to audit.

The real-world evidence study from the CASPIAN trial was also presented at ESMO, and I think it reflects the importance of confirming clinical trial data with real-world evidence.

I think there's an expectation that the public wants to see that what we find in clinical trials is reproducible, and is reproducible in the real world.

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