Real-World CLINATEZO Analysis Confirms Landmark Survival Outcomes With Atezolizumab Plus Chemotherapy in Extensive-Stage Small Cell Lung Cancer
Clinical Summary:
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Design/Population: The CLINATEZO study was a multicenter, real-world retrospective analysis of 517 patients with extensive-stage small cell lung cancer (ES-SCLC) treated with first-line atezolizumab plus platinum-based chemotherapy across 65 centers.
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Key Outcomes: Median real-world progression-free survival was 5.2 months and median overall survival was 11.3 months, consistent with pivotal clinical trials. A subset of patients achieved durable disease control and prolonged survival exceeding 4 years, with favorable outcomes associated with former smoking status, good performance status, younger age, limited-stage disease at diagnosis, and prior platinum exposure.
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Clinical Relevance: These findings demonstrate that durable long-term benefit with first-line chemoimmunotherapy is achievable in a subset of patients with ES-SCLC and identify clinical characteristics associated with prolonged survival that warrant prospective validation.
Results from the multicenter, real-world CLINATEZO study demonstrated that a subset of patients with extensive-stage small cell lung cancer (ES-SCLC) treated with first-line atezolizumab plus platinum-based chemotherapy achieved durable disease control and prolonged survival exceeding 4 years.
"SCLC is a highly aggressive type of lung cancer for which combination of chemotherapy and anti–PD-1 and PD-L1 agents is standard of care," stated Lionel Falchero, MD, Centre Hospitalier, France, and coauthors. "However, long-term follow-up data have not yet been made available from real-world cohorts of patients with SCLC who received chemotherapy and immunotherapy."
This nationwide, noninterventional retrospective analysis included 517 consecutive patients with ES-SCLC treated with first-line atezolizumab plus platinum-based chemotherapy across 65 centers in France between May 2019 and March 2020. Long-term disease control was defined as real-world progression-free survival (PFS) greater than 12 months, and long-term survival was defined as overall survival (OS) greater than 24 months.
After a median follow-up of 53.8 months, median PFS was 5.2 months, with 12-month and 48-month PFS rates of 14.6% and 6.8%, respectively. Median OS was 11.3 months, with corresponding 24-month and 48-month OS rates of 21.1% and 11.4%, respectively.
Sixty-five patients (12.6%) achieved durable disease control lasting more than 12 months. These patients experienced a median OS of 53.7 months compared with 9.7 months among patients with PFS of ≤12 months. Former smoking status and an Eastern Cooperative Oncology Group performance status of 0 to 1 were associated with durable disease control in baseline analyses.
Long-term survival exceeding 24 months was observed in 106 patients (20.5%), who achieved a median OS of 52.9 months compared with 8.8 months among patients with shorter survival (P < .0001). Younger age, limited-stage disease at the initial diagnosis of SCLC, and previous platinum-based chemotherapy were associated with long-term survival in baseline analyses, although greater cumulative smoking exposure was the only independent predictor in multivariable analysis.
"CLINATEZO demonstrates the reproducibility of the key survival outcomes of landmark trials, in a real-life setting, for patients with ES-SCLC," concluded Dr Falchero et al. "Only low smoking history and performance status were associated with long-term response in our cohort."
Source:
Falchero L, Amrane K, Godbert B, et al. Long-term response and survival in extensive stage small cell lung cancer receiving atezolizumab plus chemotherapy in a real-world setting: IFCT-1905 CLINATEZO. JTO Clin Res Rep. Published online: January 31, 2026. doi: 10.1016/j.jtocrr.2026.100964
