{"title":"免疫检查点抑制剂联合铂基双药化疗治疗东部合作肿瘤大分期小细胞肺癌患者的疗效：一项单机构回顾性研究","authors":"Kosuke Sakai, Shigeru Ishii, Shin Yokosuka, Tomoyuki Takahashi, Yuichiro Kawano, Hiroaki Nishimura, Yoshiki Kuwabara, Maiko Sasaki-Toda, Yumiko Ogawa-Kobayashi, Satoshi Kikuchi, Yusuke Hirata, Hiroyuki Kyoyama, Gaku Moriyama, Nobuyuki Koyama, Kazutsugu Uematsu","doi":"10.1002/cam4.71136","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The prognosis of small-cell lung cancer (SCLC) remains poor, particularly in patients with extensive-stage SCLC. The IMpower133 and CASPIAN trials revealed the efficacy of immune checkpoint inhibitors (ICIs) in extensive-stage SCLC patients with good performance status (PS). The aim of this study was to investigate the efficacy of ICIs in patients with poor PS.</p>\n </section>\n \n <section>\n \n <h3> Patients and Methods</h3>\n \n <p>Patients with extensive-stage SCLC who visited Saitama Medical Center, Saitama Medical University (Kawagoe, Japan) (September 2019–December 2022) were enrolled and followed up until February 2024. Objective response rate (ORR) and overall survival (OS) were compared between patients who received platinum-based doublet chemotherapy with an ICI (atezolizumab or durvalumab; ICI group) and those treated with platinum-based doublet chemotherapy alone (non-ICI group). Results were stratified by the Eastern Cooperative Oncology Group performance status (ECOG-PS) (i.e., 0–1 and 2–3).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 74 patients were included in the study (median OS: 327 days). In patients with ECOG-PS 0–1, ORR was 76.5% and 56.5% in the ICI group (<i>n</i> = 17) and non-ICI group (<i>n</i> = 23), respectively; OS was 406 and 379 days, respectively. In patients with ECOG-PS 2–3, ORR was 93.3% and 56.3% in the ICI group (<i>n</i> = 15) and non-ICI group (<i>n</i> = 16), respectively; OS was 446 days and 169 days, respectively. This evidence indicates that the addition of an ICI significantly improved OS (<i>p</i> = 0.00661) and enhanced ORR.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In patients with extensive-stage SCLC and ECOG-PS 2–3, the addition of atezolizumab or durvalumab to platinum-doublet chemotherapies improved the ORR, resulting in a better prognosis. These findings suggest that chemoimmunotherapy may be a feasible treatment option beyond the ideal clinical trial populations, addressing an unmet clinical need.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 17","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71136","citationCount":"0","resultStr":"{\"title\":\"Efficacy of Immune Checkpoint Inhibitors in Combination With Platinum-Based Doublet Chemotherapy for Extensive-Stage Small-Cell Lung Cancer Patients With Eastern Cooperative Oncology Group-Performance Status 2–3: A Single-Institution Retrospective Study\",\"authors\":\"Kosuke Sakai, Shigeru Ishii, Shin Yokosuka, Tomoyuki Takahashi, Yuichiro Kawano, Hiroaki Nishimura, Yoshiki Kuwabara, Maiko Sasaki-Toda, Yumiko Ogawa-Kobayashi, Satoshi Kikuchi, Yusuke Hirata, Hiroyuki Kyoyama, Gaku Moriyama, Nobuyuki Koyama, Kazutsugu Uematsu\",\"doi\":\"10.1002/cam4.71136\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The prognosis of small-cell lung cancer (SCLC) remains poor, particularly in patients with extensive-stage SCLC. The IMpower133 and CASPIAN trials revealed the efficacy of immune checkpoint inhibitors (ICIs) in extensive-stage SCLC patients with good performance status (PS). The aim of this study was to investigate the efficacy of ICIs in patients with poor PS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patients and Methods</h3>\\n \\n <p>Patients with extensive-stage SCLC who visited Saitama Medical Center, Saitama Medical University (Kawagoe, Japan) (September 2019–December 2022) were enrolled and followed up until February 2024. Objective response rate (ORR) and overall survival (OS) were compared between patients who received platinum-based doublet chemotherapy with an ICI (atezolizumab or durvalumab; ICI group) and those treated with platinum-based doublet chemotherapy alone (non-ICI group). Results were stratified by the Eastern Cooperative Oncology Group performance status (ECOG-PS) (i.e., 0–1 and 2–3).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 74 patients were included in the study (median OS: 327 days). In patients with ECOG-PS 0–1, ORR was 76.5% and 56.5% in the ICI group (<i>n</i> = 17) and non-ICI group (<i>n</i> = 23), respectively; OS was 406 and 379 days, respectively. In patients with ECOG-PS 2–3, ORR was 93.3% and 56.3% in the ICI group (<i>n</i> = 15) and non-ICI group (<i>n</i> = 16), respectively; OS was 446 days and 169 days, respectively. This evidence indicates that the addition of an ICI significantly improved OS (<i>p</i> = 0.00661) and enhanced ORR.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>In patients with extensive-stage SCLC and ECOG-PS 2–3, the addition of atezolizumab or durvalumab to platinum-doublet chemotherapies improved the ORR, resulting in a better prognosis. These findings suggest that chemoimmunotherapy may be a feasible treatment option beyond the ideal clinical trial populations, addressing an unmet clinical need.</p>\\n </section>\\n </div>\",\"PeriodicalId\":139,\"journal\":{\"name\":\"Cancer Medicine\",\"volume\":\"14 17\",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.71136\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cam4.71136\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.71136","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Efficacy of Immune Checkpoint Inhibitors in Combination With Platinum-Based Doublet Chemotherapy for Extensive-Stage Small-Cell Lung Cancer Patients With Eastern Cooperative Oncology Group-Performance Status 2–3: A Single-Institution Retrospective Study
Background
The prognosis of small-cell lung cancer (SCLC) remains poor, particularly in patients with extensive-stage SCLC. The IMpower133 and CASPIAN trials revealed the efficacy of immune checkpoint inhibitors (ICIs) in extensive-stage SCLC patients with good performance status (PS). The aim of this study was to investigate the efficacy of ICIs in patients with poor PS.
Patients and Methods
Patients with extensive-stage SCLC who visited Saitama Medical Center, Saitama Medical University (Kawagoe, Japan) (September 2019–December 2022) were enrolled and followed up until February 2024. Objective response rate (ORR) and overall survival (OS) were compared between patients who received platinum-based doublet chemotherapy with an ICI (atezolizumab or durvalumab; ICI group) and those treated with platinum-based doublet chemotherapy alone (non-ICI group). Results were stratified by the Eastern Cooperative Oncology Group performance status (ECOG-PS) (i.e., 0–1 and 2–3).
Results
A total of 74 patients were included in the study (median OS: 327 days). In patients with ECOG-PS 0–1, ORR was 76.5% and 56.5% in the ICI group (n = 17) and non-ICI group (n = 23), respectively; OS was 406 and 379 days, respectively. In patients with ECOG-PS 2–3, ORR was 93.3% and 56.3% in the ICI group (n = 15) and non-ICI group (n = 16), respectively; OS was 446 days and 169 days, respectively. This evidence indicates that the addition of an ICI significantly improved OS (p = 0.00661) and enhanced ORR.
Conclusion
In patients with extensive-stage SCLC and ECOG-PS 2–3, the addition of atezolizumab or durvalumab to platinum-doublet chemotherapies improved the ORR, resulting in a better prognosis. These findings suggest that chemoimmunotherapy may be a feasible treatment option beyond the ideal clinical trial populations, addressing an unmet clinical need.
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.
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