Second-line therapy in ES-SCLC gave a median OS of 7.1 months in the Austrian LALUCA registry

Little more than a third of patients reached second-line treatment

Of the 203 patients in the registry, 75 received a second line of systemic therapy. For the 128 who did not, the main reasons recorded at data cut-off were death (49.2% of that group) and a switch to best supportive care (18.8%).

For those who did go on to second-line therapy, the median time to next treatment from first to second line was 6.4 months, with a range from 0.3 to 38.7 months.

Anthracycline-based regimens were used more often than topotecan

Until recently, topotecan was the only second-line treatment approved for ES-SCLC in Europe, and the authors note that its limited efficacy has led clinicians to use a range of other strategies. In this registry, anthracycline-based regimens accounted for 57.3% of second-line treatment, against 26.7% for topotecan.

The remaining 16.0% of patients were re-challenged with platinum-based chemotherapy or chemoimmunotherapy. The data come from a registry of real-world care, so these shares describe what the participating centres used.

A median PFS of 4.7 months after two months of treatment

Across the 75 treated patients, median PFS was 4.7 months (95% CI 3.9 to 5.8) and median OS was 7.1 months (95% CI 5.1 to 9.3). The median duration of second-line treatment was 2 months, with a range of 0.0 to 8.2 months.

These are observational outcomes from a registry, with no comparator arm. The figures describe the 75 treated patients as a whole, who are 36.9% of the 203 in the registry.

“This real-world analysis shows poor outcomes in patients with progressing ES-SCLC, reflected by both short median PFS and duration of second-line treatment, along with high rates of treatment discontinuation due to progression, highlighting the urgent need for more effective and tolerable treatment options.”Moser et al., Lung Cancer (2026)

Progression ended second-line treatment in 30.7% of patients

Among those treated, disease progression was the most frequent reason for discontinuation, ahead of completion of the planned regimen in 24.0% and death in 13.3%. Taken together, these three reasons cover 68.0% of the treated patients.

The registry’s primary outcomes were OS, PFS and time to next treatment, and the authors’ conclusion rests on the short median PFS, the short treatment duration and the rate of discontinuation because of progression. The abstract does not describe the first-line regimens the patients received.