Evaluation of Efficacy and Safety in First-Line Treatment Methods for Extensive-Stage Small Cell Lung Cancer: A Comprehensive Comparative Study of Chemotherapy, Targeted Therapy Combined With Chemotherapy, and Immunotherapy Combined With Chemotherapy

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-08-08 DOI:10.1111/crj.13819

Tiantian Zhang, Lu Tao, Yufo Chen, Shanshan Zhang, Yang Liu, Yumei Li, Rui Wang

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Abstract

Background

Small cell lung cancer (SCLC) is a highly aggressive tumor with limited effectiveness in its standard chemotherapy treatment. Targeted antiangiogenic therapy and immune checkpoint inhibitors (ICIs) have demonstrated potential as alternative treatments for extensive-stage SCLC (ES-SCLC). However, there is insufficient comparative evidence available to determine the optimal first-line treatment option between ICIs plus chemotherapy and targeted antiangiogenic therapy plus chemotherapy.

Objective

This study is aimed at analyzing clinical data from ES-SCLC patients treated at the First Affiliated Hospital of Bengbu Medical College between June 2021 and June 2023. The study compared the efficacy and safety of three first-line treatment regimens: standard chemotherapy, antiangiogenic therapy combined with chemotherapy, and immune combination therapy.

Methods

Patients who met the inclusion criteria were divided into three groups: chemotherapy, immune combination therapy, and antiangiogenic therapy combined with chemotherapy. The study collected data on clinical characteristics, treatment regimens, and adverse reactions. The analysis included objective response rate (ORR), duration of response (DoR), disease control rate (DCR), progression-free survival (PFS), and treatment safety.

Results

A total of 101 patients were included in the study, with 49 receiving chemotherapy alone, 19 receiving antiangiogenic therapy, and 33 receiving immune combination therapy. The ORRs were 78.9% for antiangiogenic therapy, 72.7% for immune combination therapy, and 42.9% for chemotherapy alone. The median PFS was 8.0 months for antiangiogenic therapy, 7.8 months for immune combination therapy, and 5.2 months for chemotherapy alone. Both combination therapy groups demonstrated superior efficacy compared to chemotherapy alone.

Conclusion

Targeted combined chemotherapy and immune combination chemotherapy showed superior efficacy as first-line treatments for ES-SCLC compared to chemotherapy alone, with manageable adverse reactions.

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评估广泛期小细胞肺癌一线治疗方法的有效性和安全性：化疗、靶向治疗联合化疗以及免疫治疗联合化疗的综合比较研究》（A comprehensive Comparative Study of Chemotherapy, Targeted Therapy Combined With Chemotherapy, and Immunotherapy Combined With Chemotherapy）。

背景：小细胞肺癌（SCLC小细胞肺癌（SCLC）是一种高度侵袭性肿瘤，其标准化疗疗效有限。靶向抗血管生成疗法和免疫检查点抑制剂（ICIs）作为广泛期小细胞肺癌（ES-SCLC）的替代疗法已显示出潜力。然而，目前还没有足够的比较证据来确定ICIs加化疗与靶向抗血管生成疗法加化疗之间的最佳一线治疗方案：本研究旨在分析 2021 年 6 月至 2023 年 6 月期间在蚌埠医学院第一附属医院接受治疗的 ES-SCLC 患者的临床数据。研究比较了标准化疗、抗血管生成治疗联合化疗和免疫联合治疗三种一线治疗方案的疗效和安全性：符合纳入标准的患者被分为三组：化疗组、免疫联合疗法组和抗血管生成疗法联合化疗组。研究收集了临床特征、治疗方案和不良反应的数据。分析包括客观反应率（ORR）、反应持续时间（DoR）、疾病控制率（DCR）、无进展生存期（PFS）和治疗安全性：共有101名患者参与了研究，其中49人接受了单独化疗，19人接受了抗血管生成疗法，33人接受了免疫联合疗法。抗血管生成疗法的ORR为78.9%，免疫联合疗法的ORR为72.7%，单纯化疗的ORR为42.9%。抗血管生成疗法的中位 PFS 为 8.0 个月，免疫联合疗法为 7.8 个月，单独化疗为 5.2 个月。与单纯化疗相比，两组联合疗法均显示出更优越的疗效：结论：靶向联合化疗和免疫联合化疗作为ES-SCLC的一线治疗手段，疗效优于单纯化疗，且不良反应可控。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)