Real-World Long-Term Efficacy of Chemoimmunotherapy in Advanced Stage Small-Cell Lung Cancer.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2026-07-02 DOI:10.1159/000553352

Arne Peeters, Els Wauters, Isabelle Wauters, Karolien Van Hove, Christophe Dooms

{"title":"Real-World Long-Term Efficacy of Chemoimmunotherapy in Advanced Stage Small-Cell Lung Cancer.","authors":"Arne Peeters, Els Wauters, Isabelle Wauters, Karolien Van Hove, Christophe Dooms","doi":"10.1159/000553352","DOIUrl":null,"url":null,"abstract":"Introduction: Since IMpower133 and CASPIAN phase 3 trials, chemoimmunotherapy has become the first-line systemic treatment for advanced-stage small-cell lung carcinoma (SCLC). We conducted a study on the long-term efficacy.Methods: A retrospective cohort study was performed on advanced-stage SCLC patients who initiated treatment with first-line carboplatin-etoposide-atezolizumab between January 2018 and December 2022 at the University Hospitals Leuven. Follow-up data were collected until February 2025. The Kaplan-Meier method was used for estimating survival outcomes, and Cox regression models were used to assess the association between baseline clinical characteristics (age, ECOG Performance Status, metastatic sites, s-albumin, s-lactate dehydrogenase, s-C-reactive protein, s-NSE, neutrophil-lymphocyte ratio [NLR], modified Glasgow Prognostic Score [mGPS], and Lung Immune Prognostic Index [LIPI] score) and survival outcomes.Results: A total of 74 patients were included. The median progression-free survival (PFS) was 4.8 months (95% CI: 4.5-5.0), and median overall survival (OS) was 11.5 months (95% CI: 8.9-14.6). The 1-, 2-, and 5-year PFS and OS rates were 16.2% (95% CI: 8.9-25.5), 9.5% (95% CI: 4.2-17.4), and 8.1% (95% CI: 3.3-15.7) and 47.3% (95% CI: 35.6-58.1), 18.9% (95% CI: 11.0-28.5), and 8.9% (95% CI: 3.2-18.2%), respectively. In multivariable analysis, bone metastasis (HR 2.21; 95% CI: 1.26-3.87), age (+1 year, HR 1.03; 95% CI: 1.00-1.07), s-NSE >250 μg/L (HR 4.55; 95% CI: 2.13-9.72), and s-albumin ≥35 g/dL (HR 0.49; 95% CI: 0.25-0.99) were significantly associated with OS. During induction phase, chemotherapy dose reduction and discontinuation occurred in 31% and 8%, respectively. Overall, immune-related adverse events occurred in 21 patients (28%), leading to discontinuation of atezolizumab in 7 patients (10%).Conclusion: Our study provides long-term safety and efficacy outcomes of first-line chemoimmunotherapy in a real-world cohort of advanced-stage SCLC. In multivariable analysis, we found that baseline conventional biomarkers (age, bone metastasis, s-albumin, and s-NSE) did significantly predict OS, while systemic inflammation scores (NLR, mGPS, and LIPI) did not.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-13"},"PeriodicalIF":2.6000,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiration","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000553352","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Since IMpower133 and CASPIAN phase 3 trials, chemoimmunotherapy has become the first-line systemic treatment for advanced-stage small-cell lung carcinoma (SCLC). We conducted a study on the long-term efficacy.

Methods: A retrospective cohort study was performed on advanced-stage SCLC patients who initiated treatment with first-line carboplatin-etoposide-atezolizumab between January 2018 and December 2022 at the University Hospitals Leuven. Follow-up data were collected until February 2025. The Kaplan-Meier method was used for estimating survival outcomes, and Cox regression models were used to assess the association between baseline clinical characteristics (age, ECOG Performance Status, metastatic sites, s-albumin, s-lactate dehydrogenase, s-C-reactive protein, s-NSE, neutrophil-lymphocyte ratio [NLR], modified Glasgow Prognostic Score [mGPS], and Lung Immune Prognostic Index [LIPI] score) and survival outcomes.

Results: A total of 74 patients were included. The median progression-free survival (PFS) was 4.8 months (95% CI: 4.5-5.0), and median overall survival (OS) was 11.5 months (95% CI: 8.9-14.6). The 1-, 2-, and 5-year PFS and OS rates were 16.2% (95% CI: 8.9-25.5), 9.5% (95% CI: 4.2-17.4), and 8.1% (95% CI: 3.3-15.7) and 47.3% (95% CI: 35.6-58.1), 18.9% (95% CI: 11.0-28.5), and 8.9% (95% CI: 3.2-18.2%), respectively. In multivariable analysis, bone metastasis (HR 2.21; 95% CI: 1.26-3.87), age (+1 year, HR 1.03; 95% CI: 1.00-1.07), s-NSE >250 μg/L (HR 4.55; 95% CI: 2.13-9.72), and s-albumin ≥35 g/dL (HR 0.49; 95% CI: 0.25-0.99) were significantly associated with OS. During induction phase, chemotherapy dose reduction and discontinuation occurred in 31% and 8%, respectively. Overall, immune-related adverse events occurred in 21 patients (28%), leading to discontinuation of atezolizumab in 7 patients (10%).

Conclusion: Our study provides long-term safety and efficacy outcomes of first-line chemoimmunotherapy in a real-world cohort of advanced-stage SCLC. In multivariable analysis, we found that baseline conventional biomarkers (age, bone metastasis, s-albumin, and s-NSE) did significantly predict OS, while systemic inflammation scores (NLR, mGPS, and LIPI) did not.

查看原文本刊更多论文

化疗免疫疗法治疗晚期小细胞肺癌的长期疗效。

自IMPOWER-133和CASPIAN 3期临床试验以来，化学免疫疗法已成为晚期小细胞肺癌（SCLC）的一线全身治疗。我们对其长期疗效进行了研究。方法：对2018年1月至2022年12月在鲁汶大学医院开始接受一线卡铂-依托泊肽-阿特唑单抗治疗的晚期SCLC患者进行回顾性队列研究。随访数据收集至2025年2月。Kaplan Meier法用于估计生存结局，Cox回归模型用于评估基线临床特征（年龄、ECOG表现状态、转移部位、s-白蛋白、s-LDH、s-CRP、s-NSE、中性粒细胞淋巴细胞比（NLR）、改良格拉斯哥预后评分（mGPS）和LIPI评分）与生存结局之间的关系。结果：共纳入74例患者。中位无进展生存期（PFS）为4.8个月（95%CI 4.5-5.0），中位总生存期（OS）为11.5个月（95%CI 8.9-14.6）。1年、2年和5年PFS和OS分别为16.2% （95%CI 8.9-25.5）、9.5% （95%CI 4.2-17.4）和8.1% (95%CI 3.3-15.7), 47.3% （95%CI 35.6-58.1）、18.9% （95%CI 11.0-28.5）和8.9% （95%CI 3.2-18.2%）。在多变量分析中，骨转移（HR 2.21; 95%CI 1.26-3.87）、年龄（+1岁，HR 1.03; 95%CI 1.00-1.07）、s-NSE >250µg/L （HR 4.55; 95%CI 2.13-9.72）、s-白蛋白≥35g/dl （HR 0.49; 95%CI 0.25-0.99）与OS显著相关。诱导期化疗剂量减少和停药发生率分别为31%和8%。总体而言，irae发生在21例（28%）患者中，导致7例（10%）患者停用atezolizumab。结论：我们的研究提供了一线化学免疫治疗在现实世界中晚期SCLC队列中的长期安全性和有效性结果。在多变量分析中，我们发现基线常规生物标志物（年龄、骨转移、s-白蛋白和s-NSE）确实能显著预测总生存，而全身炎症评分（NLR、mGPS和LIPI）则不能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.