PDF(Pubmed)
Abstract：
The current first-line standard treatment for advanced small cell lung cancer (SCLC) is a combination of chemotherapy and immunotherapy. However, few efficacy data are available in a real-life settings, including frail patients. The aim of this study is to describe the real-life efficacy of chemoimmunotherapy in an unselected SCLC population. We conducted a retrospective multicenter study, which compared two cohorts of patients with treatment-naive metastatic SCLC treated in six academic centers in the Greater Paris area. Cohort 1 included patients treated with chemotherapy between January 2017 and December 2018, and cohort 2 included patients treated with chemoimmunotherapy between January 2019 and December 2020. A total of 153 consecutive patients were included (cohort 1: n = 96; cohort 2: n = 57). Clinical characteristics were similar between the two cohorts. Overall survival (OS) was statistically higher in cohort 2 (median survival 15.47 months) than in cohort 1 (median survival 9.5 months) (p = 0.0001). OS for patients with a performance status ≥2 and for patients ≥70 years old was not statistically different between the two cohorts. Chemoimmunotherapy efficacy was better compared to chemotherapy alone in case of brain or liver metastases. In conclusion, the combination of chemoimmunotherapy in metastatic SCLC appears to provide a real-life OS benefit. Dedicated clinical trials are needed to test this strategy in patients with impaired performance status or advanced age.
摘要：
目前，晚期小细胞肺癌（SCLC）的一线标准治疗方法是化疗和免疫疗法的结合。然而,在现实生活中很少有疗效数据，包括虚弱的病人。这项研究的目的是描述未经选择的SCLC人群中化学免疫疗法的真实疗效。我们进行了一项回顾性多中心研究，比较了在大巴黎地区六个学术中心接受治疗的未治疗转移性SCLC的两组患者。队列1包括2017年1月至2018年12月接受化疗的患者，队列2包括2019年1月至2020年12月接受化学免疫治疗的患者。共纳入153名连续患者(队列1:n=96;队列2:n=57)。两组患者的临床特征相似。队列2（中位生存期15.47个月）的总生存期（OS）高于队列1（中位生存期9.5个月）（p=0.0001）。表现状态≥2的患者和≥70岁的患者的OS在两个队列之间没有统计学差异。在脑或肝转移的情况下，化学免疫疗法的疗效优于单独的化学疗法。总之,转移性SCLC中化学免疫治疗的组合似乎提供了真实的OS获益.需要专门的临床试验来测试这种策略在功能受损或高龄的患者中。
