Efficacy and Safety Evaluation of Immune Checkpoint Inhibitors in Combination With Chemotherapy for Extensive Small Cell Lung Cancer: Real-World Evidence

IF 3.5 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-12-19 DOI:10.1002/cam4.70480

Yuta Yamanaka, Yukiko Okuno, Keisuke Kamisako, Yuta Okazaki, Kentaro Nakanishi, Yume Sanada, Kiyori Yoshida, Tatsuki Ikoma, Yuki Takeyasu, Utae Katsushima, Hiroshige Yoshioka, Takayasu Kurata

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Abstract

Introduction

Extensive small cell lung cancer (ES-SCLC) are currently managed using first-line chemotherapy options, including atezolizumab (Atezo) plus etoposide and carboplatin (CE) or durvalumab (Durva) plus etoposide with either cisplatin (PE) or carboplatin (CE). However, a definitive distinction in therapeutic effects between Atezo and Durva in these regimens remains unestablished.

Methods

We analyzed data from 100 patients diagnosed with ES-SCLC who received immune checkpoint inhibitors (ICIs) as first-line chemotherapy. Among them, 70 were administered Atezo + CE, 12 received Durva + PE, and 18 received Durva + CE. We assessed the efficacy of the two ICIs across various factors.

Results

The progression-free survival (PFS) and overall survival (OS) did not significantly differ between Atezo + CE and Durva + CE/PE as first-line chemotherapy treatments for SCLC. We observed no significant differences in age, sex, performance status (PS), liver metastasis, bone metastasis, or platinum-based agent usage between the treatment cohorts. However, a marked improvement in PFS and OS was observed in the solitary patient with brain metastasis treated with Atezo + CE.

Conclusion

The primary distinction between these treatments was observed in the management of patients with brain metastasis. The literature lacks comparative studies on the effects of first-line ICI treatment on the central nervous system, rendering our findings significant in clinical practice. Despite the retrospective nature of this study and the potential for various biases, we recommend the preferential use of Atezo + CE in patients with brain metastasis to potentially enhance prognosis.

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免疫检查点抑制剂联合化疗治疗广泛小细胞肺癌的疗效和安全性评价：真实世界证据

广泛的小细胞肺癌（ES-SCLC）目前使用一线化疗方案进行治疗，包括atezolizumab (Atezo) +依托泊苷和卡铂（CE）或durvalumab (Durva) +依托泊苷与顺铂（PE）或卡铂（CE）。然而，在这些方案中，Atezo和Durva之间的治疗效果的明确区别仍未确定。方法：我们分析了100例被诊断为ES-SCLC的患者的数据，这些患者接受了免疫检查点抑制剂（ICIs）作为一线化疗。其中Atezo + CE组70例，Durva + PE组12例，Durva + CE组18例。我们通过各种因素评估了两种ICIs的疗效。结果：Atezo + CE与Durva + CE/PE一线化疗治疗SCLC的无进展生存期（PFS）和总生存期（OS）无显著差异。我们观察到治疗队列之间在年龄、性别、运动状态（PS）、肝转移、骨转移或铂类药物使用方面没有显著差异。然而，在单独的脑转移患者中，Atezo + CE治疗的PFS和OS有明显改善。结论：在脑转移患者的治疗中观察到这些治疗方法的主要区别。文献缺乏一线ICI治疗对中枢神经系统影响的比较研究，因此我们的发现在临床实践中具有重要意义。尽管这项研究是回顾性的，并且可能存在各种偏差，但我们建议在脑转移患者中优先使用Atezo + CE，以潜在地改善预后。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.