Real-world effectiveness of first-line chemoimmunotherapy versus chemotherapy in older adults with extensive-stage small cell lung cancer: an inverse probability treatment weighted analysis.

IF 3.1 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2026-10-20 DOI:10.1080/14796694.2026.2750718

Siyuan Cui, Kui Zhao, Na Wang, Yuan Meng, Xiaoshan Wang, Chaoran Wang, Fanming Kong

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引用次数: 0

Abstract

Aims: First-line chemoimmunotherapy (ICI-chemo) has become the standard of care for extensive-stage small cell lung cancer (ES-SCLC). However, older adults are underrepresented in pivotal trials due to strict inclusion criteria that limit participation to highly selected, fit patients. Given the limited real-world comparative data, this study aimed to determine whether older adults with ES-SCLC derive greater benefit from ICI-chemo compared with chemotherapy (chemo) alone.

Patients and methods: We conducted a single-center retrospective cohort study including ES-SCLC patients aged 65 years or older who started first-line ICI-chemo or chemo between January 2020 and July 2024. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline confounding. The main outcome was overall survival (OS) in the IPTW population.

Results: In the IPTW population, median OS was significantly longer in the ICI-chemo group (14.95 months; 95% CI, 12.94-19.91) compared with chemo (10.28 months; 95% CI, 8.11-13.17; HR, 0.66; 95% CI, 0.48-0.91; p = 0.011). Multivariable analysis confirmed that ICI-chemo exposure was independently associated with improved OS (HR, 0.608; 95% CI, 0.440-0.841; p = 0.003).

Conclusions: Our findings provide comparative evidence of improved survival in association with ICI-chemo compared with chemo in older adults with ES-SCLC.

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一线化疗免疫治疗与化疗在老年广泛期小细胞肺癌患者中的实际疗效：一项逆概率治疗加权分析

目的：一线化疗免疫治疗（ICI-chemo）已成为广泛期小细胞肺癌（ES-SCLC）的标准治疗方案。然而，老年人在关键试验中的代表性不足，因为严格的纳入标准限制了高度选择，适合患者的参与。鉴于有限的真实世界比较数据，本研究旨在确定老年ES-SCLC患者是否从ici化疗中获得比单独化疗更大的益处。患者和方法：我们进行了一项单中心回顾性队列研究，纳入了2020年1月至2024年7月期间开始一线ici化疗或化疗的65岁及以上ES-SCLC患者。使用治疗加权逆概率（IPTW）来调整基线混淆。主要终点是IPTW患者的总生存期（OS）。结果：在IPTW人群中，ici -化疗组的中位生存期（14.95个月，95% CI, 12.94-19.91）明显长于化疗组（10.28个月，95% CI, 8.11-13.17； HR, 0.66; 95% CI, 0.48-0.91; p = 0.011）。多变量分析证实，CI-化疗暴露与OS改善独立相关（HR, 0.608; 95% CI, 0.440-0.841; p = 0.003）。结论：我们的研究结果提供了与化疗相比，ici化疗与ES-SCLC老年患者生存率提高相关的比较证据。

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来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.