Frontiers in pharmacology · 2026
Efficacy and safety of first-line immunotherapy-related induction and maintenance therapy for extensive-stage small cell lung cancer: a systematic review and Bayesian network meta-analysis.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yu Hong-Jing, Liu Jun-Chen, Zhang Dong-Sheng, Chen Zhi, Deng Qi
Аннотация
BACKGROUND: Extensive-stage small cell lung cancer (ES-SCLC) is highly aggressive with dismal prognosis, and platinum monochemotherapy offers modest long-term survival. Multiple first-line regimens integrating immunotherapy, anti-angiogenic agents and chemotherapy have been approved, yet direct head-to-head comparisons are scarce, and the optimal induction plus maintenance strategy remains undefined. In this study, a Bayesian network meta-analysis (NMA) was performed to hierarchically assess the efficacy and safety of available first-line regimens and identify balanced treatment strategies for ES-SCLC.
METHODS: Eligible phase III randomized controlled trials (RCTs) were identified by searching PubMed, Embase, the Cochrane Library, and Web of Science. Trials were included if they enrolled treatment-naïve patients with ES-SCLC and reported at least one of the following outcomes: overall survival (OS), progression-free survival (PFS), or grade ≥3 treatment-related adverse events (TRAEs). NMA was implemented using the gemtc package in R. SUCRA values were calculated for treatment ranking, and subgroup analyses stratified by pharmacological mechanisms were conducted.
RESULTS: Fourteen RCTs involving 8,945 patients across 18 regimens were included in the present analysis. These trials encompassed diverse combinations of mainstream immune checkpoint inhibitors, anti-angiogenic targeted agents, and chemotherapeutic agents. The atezolizumab + lurbinectedin + chemotherapy and benmelstobart + anlotinib + chemotherapy regimens showed the greatest potential for superior PFS and OS compared with chemotherapy alone. Subgroup analyses confirmed sustained efficacy benefits for PD-L1 inhibitor-based triple-combination strategies. The nivolumab + ipilimumab regimen was associated with the highest risk of severe toxicity.
CONCLUSION: PD-L1 inhibitor combined with platinum-based chemotherapy together with anti-angiogenic agents or lurbinectedin conferred optimal survival benefits, yet toxicity was correspondingly augmented. This study provides valuable insights into therapeutic drug selection for ES-SCLC.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261402898, identifier 420261402898.
METHODS: Eligible phase III randomized controlled trials (RCTs) were identified by searching PubMed, Embase, the Cochrane Library, and Web of Science. Trials were included if they enrolled treatment-naïve patients with ES-SCLC and reported at least one of the following outcomes: overall survival (OS), progression-free survival (PFS), or grade ≥3 treatment-related adverse events (TRAEs). NMA was implemented using the gemtc package in R. SUCRA values were calculated for treatment ranking, and subgroup analyses stratified by pharmacological mechanisms were conducted.
RESULTS: Fourteen RCTs involving 8,945 patients across 18 regimens were included in the present analysis. These trials encompassed diverse combinations of mainstream immune checkpoint inhibitors, anti-angiogenic targeted agents, and chemotherapeutic agents. The atezolizumab + lurbinectedin + chemotherapy and benmelstobart + anlotinib + chemotherapy regimens showed the greatest potential for superior PFS and OS compared with chemotherapy alone. Subgroup analyses confirmed sustained efficacy benefits for PD-L1 inhibitor-based triple-combination strategies. The nivolumab + ipilimumab regimen was associated with the highest risk of severe toxicity.
CONCLUSION: PD-L1 inhibitor combined with platinum-based chemotherapy together with anti-angiogenic agents or lurbinectedin conferred optimal survival benefits, yet toxicity was correspondingly augmented. This study provides valuable insights into therapeutic drug selection for ES-SCLC.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261402898, identifier 420261402898.