Background: As the therapeutic landscape in extensive stage small cell lung cancer (eSCLC) is changing, it is important to understand the real-world treatment experience of patients (pts) with eSCLC in terms of healthcare resource utilization (HCRU) and patient-reported outcomes (PROs). This study describes patient characteristics, treatment patterns, HCRU and PROs for these pts in community oncology settings. Methods: Retrospective medical records data from adults diagnosed with eSCLC between 1/1/2008 and 12/31/2017 were collected from US oncology practices. Descriptive analyses were performed on patient characteristics, treatment patterns and HCRU. Linear mixed models were used to evaluate longitudinal PROs collected from the Patient Care Monitor, a widely used survey at participating practices with index scores to indicate patient’s physical symptoms, psychiatric and physical function. Results: Among 406 pts with eSCLC, 196 (48.3%) were male, 313 (77.1%) white, and median age was 65.1 years (range 38.5-86.0 years). At diagnosis, 331 (81.5%) pts had extensive stage disease and 225 (55.4%) had brain metastasis. Of 346 pts with systemic treatment (IO-naïve) in 1st line (1L), 43 (12.4%) had impaired performance status. 255 (73.7%) used carboplatin and etoposide, followed by 43 (12.4%) with cisplatin and etoposide (in 2nd line [2L] of 196 pts, 53 (27.0%) received topotecan, 32 (16.3%) received carboplatin and etoposide). Among pts who received systemic therapy (n=346), 20.2% of pts were hospitalized, and 3.5% had emergency visits during 1L treatment. Infused supportive care drugs were used in 65.1% of impaired pts and 55.4% of non-impaired pts. Comparing pts with initial diagnosis of eSCLC to those with limited stage, index scores were significantly worse for Despair and Impaired Ambulation (p<0.05). Index scores for white pts are also significantly worse across General Physical Symptoms, Acute Distress, Despair, Impaired Ambulation, and Impaired Performance (p<0.05). Conclusions: This study suggests that pts with eSCLC had high demand on HCRU, especially impaired pts. Pts with de-novo eSCLC diagnosis were associated with worse PROs. The data also highlights the limitations of the current standard of care and existing high unmet need. In addition, these data provide a benchmark/historical perspective for future research focusing on assessing the HCRU and PROs of the anticipated new immunotherapies for the treatment of eSCLC in a real-world setting.