Abstract：
Combined small-cell lung cancer (c-SCLC) with gene mutations is a rare subtype often found alongside adenocarcinoma. Targeted therapy may be effective because of the presence of specific molecular targets. However, due to its rarity and unconventional genetic testing, the efficacy remains uncertain.
A total of 31 c-SCLC patients with gene mutations were retrospectively included and grouped according to their treatment regimens. Treatment outcomes were evaluated. Kaplan-Meier method was used for survival analysis, with Log Rank test applied for comparison between groups.
We divided the 31 patients into 3 groups according to first-line treatment: group A (chemotherapy, n = 16), group B (targeted monotherapy, n = 7), and group C (targeted combination therapy, n = 8). The overall response rates (ORR) were 43.8%, 42.9%, and 62.5%. The disease control rates (DCR) were 87.5%, 85.7%, and 100%. The median progression-free survival (PFS) was 4.0, 5.0, and 7.93 months (P = .024), with a significant difference between group A and C (P = .010). The median overall survival (OS) was 14.10, 17.43, and 12.93 months (P = .313). Seven patients in group A received targeted therapy in later-line. Of the total 22 patients received targeted monotherapy or combination therapy, the ORR and DCR were 54.5% and 90.9%. The median PFS and OS were 5.87 and 17.30 months. Additionally, adverse events (AEs) occurred in 53.8% and 88.9% of monotherapy and combination therapy. The most common AEs in monotherapy were elevated transaminases (23.1%) and in combination anemia (66.7%).
TKIs showed encouraging efficacy in driver-gene-positive c-SCLC. While monotherapy may be a supplementary option, combination with chemotherapy appears to be preferable and superior.
A total of 31 c-SCLC patients with gene mutations were retrospectively included and grouped according to their treatment regimens. Treatment outcomes were evaluated. Kaplan-Meier method was used for survival analysis, with Log Rank test applied for comparison between groups.
We divided the 31 patients into 3 groups according to first-line treatment: group A (chemotherapy, n = 16), group B (targeted monotherapy, n = 7), and group C (targeted combination therapy, n = 8). The overall response rates (ORR) were 43.8%, 42.9%, and 62.5%. The disease control rates (DCR) were 87.5%, 85.7%, and 100%. The median progression-free survival (PFS) was 4.0, 5.0, and 7.93 months (P = .024), with a significant difference between group A and C (P = .010). The median overall survival (OS) was 14.10, 17.43, and 12.93 months (P = .313). Seven patients in group A received targeted therapy in later-line. Of the total 22 patients received targeted monotherapy or combination therapy, the ORR and DCR were 54.5% and 90.9%. The median PFS and OS were 5.87 and 17.30 months. Additionally, adverse events (AEs) occurred in 53.8% and 88.9% of monotherapy and combination therapy. The most common AEs in monotherapy were elevated transaminases (23.1%) and in combination anemia (66.7%).
TKIs showed encouraging efficacy in driver-gene-positive c-SCLC. While monotherapy may be a supplementary option, combination with chemotherapy appears to be preferable and superior.
摘要：
背景：伴有基因突变的联合小细胞肺癌（c-SCLC）是一种罕见的亚型，通常与腺癌同时发现。由于存在特定的分子靶标,靶向治疗可能是有效的。然而,由于其稀有和非常规的基因检测，疗效仍不确定。
方法：回顾性纳入31例有基因突变的c-SCLC患者，并根据治疗方案分组。评估治疗结果。采用Kaplan-Meier法进行生存分析,采用LogRank检验进行组间比较。
结果：我们根据一线治疗将31例患者分为3组：A组（化疗，n=16),B组(靶向单一疗法，n=7),和C组(靶向联合治疗，n=8)。总有效率（ORR）为43.8%，42.9%,62.5%。疾病控制率(DCR)为87.5%,85.7%,和100%。中位无进展生存期（PFS）分别为4.0、5.0和7.93个月（P=0.024），A组和C组之间存在显著差异(P=.010)。中位总生存期（OS）分别为14.10、17.43和12.93个月（P=.313）。A组7例患者在后期行靶向治疗。在总共22例患者中接受靶向单一疗法或联合疗法，ORR和DCR分别为54.5%和90.9%。中位PFS和OS分别为5.87和17.30个月。此外,单药治疗和联合治疗的不良事件(AE)发生率分别为53.8%和88.9%.单药治疗中最常见的不良事件是转氨酶升高（23.1％）和联合贫血（66.7％）。
结论：TKI在驱动基因阳性c-SCLC中显示出令人鼓舞的疗效。虽然单一疗法可能是一种补充选择，联合化疗似乎是更好和更好的。
方法：回顾性纳入31例有基因突变的c-SCLC患者，并根据治疗方案分组。评估治疗结果。采用Kaplan-Meier法进行生存分析,采用LogRank检验进行组间比较。
结果：我们根据一线治疗将31例患者分为3组：A组（化疗，n=16),B组(靶向单一疗法，n=7),和C组(靶向联合治疗，n=8)。总有效率（ORR）为43.8%，42.9%,62.5%。疾病控制率(DCR)为87.5%,85.7%,和100%。中位无进展生存期（PFS）分别为4.0、5.0和7.93个月（P=0.024），A组和C组之间存在显著差异(P=.010)。中位总生存期（OS）分别为14.10、17.43和12.93个月（P=.313）。A组7例患者在后期行靶向治疗。在总共22例患者中接受靶向单一疗法或联合疗法，ORR和DCR分别为54.5%和90.9%。中位PFS和OS分别为5.87和17.30个月。此外,单药治疗和联合治疗的不良事件(AE)发生率分别为53.8%和88.9%.单药治疗中最常见的不良事件是转氨酶升高（23.1％）和联合贫血（66.7％）。
结论：TKI在驱动基因阳性c-SCLC中显示出令人鼓舞的疗效。虽然单一疗法可能是一种补充选择，联合化疗似乎是更好和更好的。
