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Abstract：
BACKGROUND: Large cell neuroendocrine carcinoma (LCNEC) presents significant treatment challenges due to its rarity and limited therapeutic options. The LANCE study was designed to explore the survival benefits of incorporating atezolizumab in chemotherapy for metastatic LCNEC.
METHODS: In this non-randomized study, patients with metastatic LCNEC were prospectively enrolled and assigned to receive either standard chemotherapy plus atezolizumab followed by maintenance with atezolizumab or standard chemotherapy alone. The primary outcomes measured were 12- and 24-month survival rates, progression-free survival (PFS), and overall survival (OS) between the two groups.
RESULTS: Of the 22 patients screened, 17 met the inclusion criteria and received either atezolizumab plus platinum-based chemotherapy (n = 10) or chemotherapy alone (n = 7). After a median follow-up of 23.3 months, the 12-month survival rate was 57.1% (95% CI: 32.6-100%) and 14.3% (95% CI: 2.33-87.7%) for the atezolizumab and the chemotherapy-only groups, respectively. The survival benefit for the atezolizumab group was sustained at 24 months (45.7% vs. 14.3%). Overall survival was significantly higher for the atezolizumab group, and PFS was non-significantly associated with the addition of atezolizumab (log-rank p = 0.04 and 0.05, respectively).
CONCLUSIONS: This pilot study suggests that the addition of atezolizumab to standard platinum-based chemotherapy may provide a substantial survival benefit compared with chemotherapy alone in the first-line treatment of metastatic LCNEC.
METHODS: In this non-randomized study, patients with metastatic LCNEC were prospectively enrolled and assigned to receive either standard chemotherapy plus atezolizumab followed by maintenance with atezolizumab or standard chemotherapy alone. The primary outcomes measured were 12- and 24-month survival rates, progression-free survival (PFS), and overall survival (OS) between the two groups.
RESULTS: Of the 22 patients screened, 17 met the inclusion criteria and received either atezolizumab plus platinum-based chemotherapy (n = 10) or chemotherapy alone (n = 7). After a median follow-up of 23.3 months, the 12-month survival rate was 57.1% (95% CI: 32.6-100%) and 14.3% (95% CI: 2.33-87.7%) for the atezolizumab and the chemotherapy-only groups, respectively. The survival benefit for the atezolizumab group was sustained at 24 months (45.7% vs. 14.3%). Overall survival was significantly higher for the atezolizumab group, and PFS was non-significantly associated with the addition of atezolizumab (log-rank p = 0.04 and 0.05, respectively).
CONCLUSIONS: This pilot study suggests that the addition of atezolizumab to standard platinum-based chemotherapy may provide a substantial survival benefit compared with chemotherapy alone in the first-line treatment of metastatic LCNEC.
摘要：
背景：大细胞神经内分泌癌（LCNEC）由于其稀有性和有限的治疗选择而提出了重大的治疗挑战。LANCE研究旨在探索在转移性LCNEC化疗中纳入阿特珠单抗的生存益处。
方法：在这项非随机研究中，有转移性LCNEC的患者被前瞻性纳入研究,并被分配接受标准化疗加阿特珠单抗,然后接受阿特珠单抗维持治疗或仅接受标准化疗.测量的主要结果是12个月和24个月的生存率，无进展生存期（PFS），两组总生存期(OS)。
结果：在筛选的22名患者中，17符合纳入标准，并接受了阿特珠单抗加铂类化疗（n=10）或单独化疗（n=7）。在中位随访23.3个月后，阿替珠单抗组和仅化疗组的12个月生存率分别为57.1%(95%CI:32.6-100%)和14.3%(95%CI:2.33-87.7%),分别。阿特珠单抗组的生存获益在24个月时持续(45.7%vs.14.3%）。阿替珠单抗组的总生存率明显较高，和PFS与阿特珠单抗的添加无显著相关(分别为log-rankp=0.04和0.05).
结论：这项初步研究表明，在转移性LCNEC的一线治疗中，与单独的化疗相比，在标准的铂类化疗中添加阿特珠单抗可能提供显著的生存益处。
方法：在这项非随机研究中，有转移性LCNEC的患者被前瞻性纳入研究,并被分配接受标准化疗加阿特珠单抗,然后接受阿特珠单抗维持治疗或仅接受标准化疗.测量的主要结果是12个月和24个月的生存率，无进展生存期（PFS），两组总生存期(OS)。
结果：在筛选的22名患者中，17符合纳入标准，并接受了阿特珠单抗加铂类化疗（n=10）或单独化疗（n=7）。在中位随访23.3个月后，阿替珠单抗组和仅化疗组的12个月生存率分别为57.1%(95%CI:32.6-100%)和14.3%(95%CI:2.33-87.7%),分别。阿特珠单抗组的生存获益在24个月时持续(45.7%vs.14.3%）。阿替珠单抗组的总生存率明显较高，和PFS与阿特珠单抗的添加无显著相关(分别为log-rankp=0.04和0.05).
结论：这项初步研究表明，在转移性LCNEC的一线治疗中，与单独的化疗相比，在标准的铂类化疗中添加阿特珠单抗可能提供显著的生存益处。
