免疫检查点抑制剂与化疗联合疗法（HOT2301）作为广泛期SCLC患者预后标志的同步寡转移和寡进展

IF 3 Q2 ONCOLOGY

JTO Clinical and Research Reports Pub Date : 2024-09-07 DOI:10.1016/j.jtocrr.2024.100715

Kana Hashimoto MD , Daisuke Morinaga MD , Hajime Asahina MD, PhD , Mina Ishidoya MD , Hajime Kikuchi MD, PhD , Hiroshi Yokouchi MD, PhD , Toshiyuki Harada MD, PhD , Osamu Honjo MD , Ryota Shigaki MD , Taichi Takashina MD, PhD , Yuka Fujita MD, PhD , Mamoru Takahashi MD, PhD , Yasutaka Kawai MD , Ryotaro Kida MD , Kenichiro Ito MD , Noriaki Sukoh MD, PhD , Ayumu Takahashi MD, PhD , Fumihiro Hommura MD, PhD , Yoshihito Ohhara MD, PhD , Megumi Furuta MD, PhD , Satoshi Oizumi MD, PhD

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引用次数: 0

摘要

导言寡转移和寡进展（OP）在广泛期SCLC（ES-SCLC）中尚未得到充分定义，可能是增加局部治疗的良好指征。因此，这项多中心研究旨在探讨ES-SCLC中寡转移和OP对预后的影响。方法我们纳入了2019年9月至2022年6月期间接受化疗免疫治疗的患者。结果我们回顾性分析了265例连续的ES-SCLC患者。同步少转移（SOM）和远处转移（OP）被定义为在少于或等于两个器官（包括肺部）出现少于或等于五个病灶；分别有21.0%和53.2%的患者出现SOM和OP。有SOM和无SOM患者的中位无进展生存期分别为5.8个月和4.9个月（危险比[HR] = 0.72，95%置信区间[CI]：0.51-1.02，P＜0.05）：0.51-1.02, p = 0.065).从一线治疗开始，SOM患者和非SOM患者的中位总生存期分别为20.5个月和15.0个月（HR = 0.58，95% CI：0.37-0.95，p = 0.027）。与非OP组相比，OP组的无进展生存期为5.2个月（相对于3.2个月，HR=0.69，95% CI：0.50-0.96，p=0.026），总生存期为15.1个月（相对于7.5个月，HR=0.44，95% CI：0.29-0.66，p=0.027）。结论SOM和OP组患者的ES-SCLC可能比非寡转移组患者更不活跃，因此应探索新的治疗策略，包括增加局部治疗。

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Synchronous Oligometastasis and Oligoprogression as a Prognostic Marker in Patients With Extensive-Stage SCLC Treated With a Combination of Immune-Checkpoint Inhibitor and Chemotherapy (HOT2301)

Introduction

Oligometastasis and oligoprogression (OP) has not been adequately defined in extensive-stage SCLC (ES-SCLC) and may be a good indication for adding local treatment. Therefore, this multicenter study aimed to investigate the prognostic impact of oligometastasis and OP in ES-SCLC.

Methods

We enrolled patients who received chemoimmunotherapy between September 2019 and June 2022. Patients were classified into oligometastasis and non-oligometastasis groups by determining the number of original tumor lesions and distant metastases (worsening or newly appearing lesions) at the time of initial diagnosis and disease progression after first-line treatment.

Results

We retrospectively analyzed 265 consecutive patients with ES-SCLC. Synchronous oligometastasis (SOM) and OP was defined as less than or equal to five lesions in less than or equal to two organs, including lungs; 21.0% and 53.2% of patients had SOM and OP, respectively. Median progression-free survival was 5.8 months and 4.9 months in patients with and without SOM, respectively (hazard ratio [HR] = 0.72, 95% confidence interval [CI]: 0.51–1.02, p = 0.065). Median overall survival was 20.5 months and 15.0 months in patients with and without SOM (HR = 0.58, 95% CI: 0.37–0.95, p = 0.027) from the initiation of first-line treatment. The OP group revealed a better progression-free survival of 5.2 months (versus 3.2 mo, HR = 0.69, 95% CI: 0.50–0.96, p = 0.026) and overall survival of 15.1 months (versus 7.5 mo, HR = 0.44, 95% CI: 0.29–0.66, p = 0.027) from the initiation of second-line treatment compared with the non-OP group. The Lung Immune Prognostic Index score was significantly lower in the SOM and OP group.

Conclusions

ES-SCLC in patients with SOM and OP may be more indolent than that of the nonoligometastasis group, therefore, new treatment strategies, including the addition of local treatment, should be explored.