Real-world Burden and Treatments of Chemotherapy-Induced Myelosuppression among Patients with Extensive-Stage Small-Cell Lung Cancer: A Retrospective Real-World Study in China.

e20102 Background: Chemotherapy-induced myelosuppression (CIM) is the major dose-limiting and severe complication for chemotherapy, particularly etoposide plus platinum-based therapy (EP), in patients with extensive-stage small-cell lung cancer (ES-SCLC). CIM adversely affects patient quality of life and imposes substantial economic burden. In China, there’s a scarcity of related studies, especially in large cohort. This study aims to summarize the burden and treatments of CIM in ES-SCLC patients using a nationally representative real-world database. Methods: Data were derived from 53 hospitals across 28 provinces, as part of the National Cancer Center (NCC) database. ES-SCLC patients receiving EP between 2018.1.1 and 2022.12.31 were included. CIM events, namely chemotherapy induced neutropenia (CIN), thrombocytopenia (CIT), and anemia (CRA) were identified based on laboratory tests and graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 5. Incidence, treatments and impact on hospitalization cost of CIM were described. Results: 7,505 patients were included, with an average age of 61.2 years (SD = 9.02) and an average of 5.0 chemotherapy cycles (SD = 2.01). The overall incidence of CIM was 91.95%, with grade 3-4 CIM occurring in 25.09% patients. Incidence of CIN, CIT, and CRA, were 44.74%, 39.20%, and 86.48%, respectively, with febrile neutropenia at 0.72%. Among patients with CIN, 90.89% patients used granulocyte colony stimulating factor (G-CSF), and 90.56% used it prophylactically. Among patients with CIT, 17.47% used recombinant human thrombopoietin (rhTPO) and 25.49% used recombinant human interleukin-11 (rhIL-11). Among patients with CRA, 10.26% used erythropoiesis-stimulating agent (ESA). Occurrence of grade 1-2 CIM and grade 3-4 CIM may increase 9.37% and 32.36% hospitalization cost per chemotherapy cycle, respectively (¥23,316.3 vs ¥21,318.2, ¥28,217.0 vs ¥21,318.2), compared to patients without any CIM. Conclusions: Incidence of CIM is notably high among ES-SCLC patients receiving EP, and treatments like G-CSF, rhTPO, rhIL-11 and ESA are widely used. Occurrence of CIM critically escalates hospitalization cost. Innovations to protect bone marrow from chemotherapy-induced damage are promising to alleviate the burden and benefit quality of life for ES-SCLC patients.[Table: see text]