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How would you treat a patient with extensive-stage small cell carcinoma and severe end-stage COPD on home oxygen?

Would you treat with chemotherapy (carboplatin/etoposide) vs anti-pd-1 monotherapy vs combination chemoimmunotherapy vs supportive care?
2 Answers
Mednet Member
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Medical Oncology · Cleveland Clinic
Answered on

I would base this decision on the patient's performance status, not solely on a diagnosis of COPD or the use of supplemental oxygen. While the IMpower 133 trial included patients with ECOG PS of 0-1, in the outpatient setting I would generally offer chemoimmunotherapy to a patient with PS 0-2. Pneum...

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Mednet Member
Mednet Member
Medical Oncology · Siri Onclogy and hematology Infusion Service
Answered on

For end-stage COPD requiring home oxygen (oxygen at rest), I would not consider 0-1 and therefore it does not resemble the IMpower 133 study. I would be most surprised if he tolerated doses of therapy and immunotherapy as prescibed in IMPOWER 133 for at best a few months of survival, with already po...

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