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Efficacy and safety of immune checkpoint inhibitors (ICIs) in extensive-stage small cell lung cancer (SCLC)

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

To evaluate the efficacy and safety of an immune checkpoint inhibitor (ICI) combined with chemotherapy in patients with advanced SCLC.

Methods

We searched published randomized-controlled trials (RCTs) to compare the effect of ICIs combined with chemotherapy and chemotherapy alone on SCLC. The extracted data included the number of people who achieved an objective response rate (ORR), the disease control rate (DCR), the hazard ratio (HR) of progression-free survival (PFS), and the overall survival (OS) with 95% confidence intervals (95% CI).

Results

Six RCTs involving 2477 patients were included. Compared with chemotherapy alone, patients receiving an ICI combined with chemotherapy had a significantly longer PFS (HR, 0.91; 95% CI 0.88–0.95, p < 0.00001) and OS (HR 0.92; 95% CI 0.89–0.96, p = 0.0001). The ORR increased, but the difference was not statistically significant (RR 1.05; 95% CI 0.99–1.12, p = 0.13). There was no significant difference in the DCR between the two treatment regimens; however, in patients treated with an ICI, fatigue, rashes, diarrhea, and elevated aminotransferase enzymes were significantly increased (p < 0.05).

Conclusion

ICI combined with chemotherapy is superior to chemotherapy alone with respect to PFS and OS in patients with advanced SCLC.

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Funding

This work was supported by National Natural Science Foundation of China (Grant No.81774221 and No.81904102), The Capital Health Research and Development of Special(No.2018-2-1113), Beijing Natural Science Foundation (No.7184203), Basic-Clinical Cooperation Program from Capital Medical University(No.17JL14), Research Foundation of Beijing Friendship Hospital, Capital Medical University (No.yyqdkt2016-4), and Beijing Municipal 215 High-level Health Person Foundation Project (No.2014-3-004).

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Authors and Affiliations

  1. Cancer Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China

    Xiaoting Ma, Shan Wang, Yujian Zhang & Jing Yu

  2. Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xi Cheng District, Beijing, 100050, China

    Huamin Wei

Authors
  1. Xiaoting Ma
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  2. Shan Wang
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  3. Yujian Zhang
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  4. Huamin Wei
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  5. Jing Yu
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Contributions

XTM and JY contributed to the conception and design this study. SW and YJZ carried out the development of the methodology. XTM and HMW analyzed and interpreted the data. JY and XTM wrote the manuscript and approved the final submission of the study. All authors read and approved the final manuscript.

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Correspondence to Huamin Wei or Jing Yu.

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Ma, X., Wang, S., Zhang, Y. et al. Efficacy and safety of immune checkpoint inhibitors (ICIs) in extensive-stage small cell lung cancer (SCLC). J Cancer Res Clin Oncol 147, 593–606 (2021). https://doi.org/10.1007/s00432-020-03362-z

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  • DOI: https://doi.org/10.1007/s00432-020-03362-z

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