Therapeutic advances in medical oncology · 2026
Efficacy and safety of different treatment regimens in patients with small cell lung cancer progressing from limited-stage to extensive-stage disease.
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Yu Minghao, Liu Yang, Wang Xiaolong, Cui Wenxing, Sun Fujia, Li Yankang, Zhao Kaikai, Zhao Hong, Meng Xiangjiao
Аннотация
BACKGROUND: Limited-stage small cell lung cancer (LS-SCLC) frequently progresses to extensive-stage disease (ES-SCLC) after standard therapy. However, evidence regarding the efficacy and safety of various treatment regimens for this specific patient population remains limited.
OBJECTIVES: This study aimed to evaluate the efficacy and safety of various treatment regimens among patients who progressed from LS-SCLC to ES-SCLC after standard chemoradiotherapy.
DESIGN: Survival analyses using propensity score matching (PSM) were conducted in patients with LS-SCLC who progressed to ES-SCLC to assess the efficacy and safety of multiple treatment regimens, especially immunotherapy.
METHODS: This retrospective study included 378 patients with LS-SCLC who progressed to ES-SCLC at Shandong Cancer Hospital from January 2018 to December 2024. After propensity score matching (PSM), patients were divided into immunotherapy and non-immunotherapy groups. Data on treatment regimens and clinical outcomes, including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS), were collected. Kaplan-Meier analysis estimated PFS and OS, and Cox regression identified factors influencing OS.
RESULTS: Median overall survival (mOS) and median progression-free survival (mPFS) in the immunotherapy group were longer than those in the non-immunotherapy group (16.4 vs 12.3 months, P < 0.05; 5.3 vs 4.9 months, P < 0.05, respectively). In an exploratory subgroup analysis, platinum-based regimens were associated with longer OS only in patients with a treatment-free interval (TFI) of 3 months or longer (median 19.3 vs 12.5 months; HR = 0.65, 95% CI 0.44-0.95, P < 0.05).
CONCLUSION: Our exploratory real-world data suggest that immunotherapy is associated with improved patient outcomes in patients with LS-SCLC who progress to ES-SCLC. Platinum-based regimens may be associated with better prognosis in the subgroup with a TFI of 3 months or longer. Given the exploratory nature, further prospective randomized trials are needed to confirm these observations.
OBJECTIVES: This study aimed to evaluate the efficacy and safety of various treatment regimens among patients who progressed from LS-SCLC to ES-SCLC after standard chemoradiotherapy.
DESIGN: Survival analyses using propensity score matching (PSM) were conducted in patients with LS-SCLC who progressed to ES-SCLC to assess the efficacy and safety of multiple treatment regimens, especially immunotherapy.
METHODS: This retrospective study included 378 patients with LS-SCLC who progressed to ES-SCLC at Shandong Cancer Hospital from January 2018 to December 2024. After propensity score matching (PSM), patients were divided into immunotherapy and non-immunotherapy groups. Data on treatment regimens and clinical outcomes, including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS), were collected. Kaplan-Meier analysis estimated PFS and OS, and Cox regression identified factors influencing OS.
RESULTS: Median overall survival (mOS) and median progression-free survival (mPFS) in the immunotherapy group were longer than those in the non-immunotherapy group (16.4 vs 12.3 months, P < 0.05; 5.3 vs 4.9 months, P < 0.05, respectively). In an exploratory subgroup analysis, platinum-based regimens were associated with longer OS only in patients with a treatment-free interval (TFI) of 3 months or longer (median 19.3 vs 12.5 months; HR = 0.65, 95% CI 0.44-0.95, P < 0.05).
CONCLUSION: Our exploratory real-world data suggest that immunotherapy is associated with improved patient outcomes in patients with LS-SCLC who progress to ES-SCLC. Platinum-based regimens may be associated with better prognosis in the subgroup with a TFI of 3 months or longer. Given the exploratory nature, further prospective randomized trials are needed to confirm these observations.