Francesco Passiglia, MD, PhD
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SUMMARY
This exploratory analysis of the RATIONALE-312 trial evaluated time to disease progression in the brain and quality-adjusted time without symptoms or toxicity (Q-TWiST) in patients with brain progressive disease (PD) with first-line extensive-stage small cell lung cancer treated with tislelizumab (TIS) plus chemotherapy (CT) or placebo (PBO) plus CT. Among 457 patients (TIS+CT, n=227; PBO+CT, n=230) with a median follow-up of 14.2 months, brain PD was assessed as time to PD in the brain per RECIST v1.1 or radiation therapy (RT) to the brain during treatment. One patient (<1%) in the TIS+CT arm and 4 (2%) in the PBO+CT arm had brain metastases at baseline. 44 patients (19%) in each arm had brain PD during the trial; 41 (18%) in TIS+CT and 34 (15%) in PBO+CT received brain RT; 3 (1%) and 1 (<1%), respectively, received prophylactic cranial irradiation. Among patients with brain PD, median progression-free survival was 5.4 months (95% CI, 4.3–5.6) with TIS+CT versus 4.4 months (95% CI, 4.2–5.7) with PBO+CT, and median overall survival was 15.5 months (95% CI, 12.3–23.5) versus 13.6 months (95% CI, 10.6–17.0), respectively. Q-TWiST showed a 28.8% improvement and an absolute gain of 4.7 months (P<0.05) for TIS+CT.
ClinicalTrials.gov ID: NCT04005716
Kohei Shitara, MD
Sun Young Rha, MD, PhD
Jordi Rodon Ahnert, MD, PhD
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