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Effect of immune checkpoint inhibitors at different treatment time periods on prognosis of patients with extensive-stage small-cell lung cancer

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Abstract

Background

The application of immune checkpoint inhibitors (ICIs) in treating patients with extensive-stage small-cell lung cancer (ES-SCLC) has brought us new hope, but the real-world outcome is relatively lacking. Our aim was to investigate the clinical use, efficacy, and survival benefit of ICIs in ES-SCLC from real-world data analysis.

Methods

A retrospective analysis of ES-SCLC patients was conducted between 2012 and 2022. Progression-free survival (PFS) and overall survival (OS) were assessed between groups to evaluate the value of ICIs at different lines of treatment. PFS1 was defined as the duration from initial therapy to disease progression or death. PFS2 was defined as the duration from the first disease progression to the second disease progression or death.

Results

One hundred and eighty patients with ES-SCLC were included. We performed landmark analysis, which showed that compared to the second-line and subsequent-lines ICIs-combined therapy group (2SL-ICIs) and non-ICIs group, the first-line ICIs-combined therapy group (1L-ICIs) prolonged OS and PFS1. There was a trend toward prolonged OS in the 2SL-ICIs group than in the non-ICIs group, but the significance threshold was not met (median OS 11.94 months vs. 11.10 months, P = 0.14). A longer PFS2 was present in the 2SL-ICIs group than in the non-ICIs group (median PFS2 4.13 months vs. 2.60 months, P < 0.001).

Conclusion

First-line ICIs plus chemotherapy should be applied in clinical practice. If patients did not use ICIs plus chemotherapy in first-line therapy, the use of ICIs in the second line or subsequent lines of treatment could prolong PFS2.

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Data availability

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Acknowledgements

The authors also appreciate the Ethics Committee of Shandong Provincial Qianfoshan Hospital, Shandong University (No. 2022-S607).

Funding

This research was funded by Shandong Natural Science Foundation (ZR202108070028 and ZR2022MH103).

Author information

Author notes

  1. Song Mi and Yunxin Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Oncology, Shandong University of Traditional Chinese Medicine, Shandong Provincial Qianfoshan Hospital, Jinan, China

    Song Mi & Jiandong Zhang

  2. Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Lung Cancer Institute, Jinan, China

    Song Mi, Xin Liu, Ning Liang, Pingping Hu & Jiandong Zhang

  3. Department of Oncology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China

    Yunxin Yang

  4. School of Clinical Medicine, Weifang Medical University, Weifang, China

    Shaotong Tang

  5. Key Laboratory of Novel Food Resources Processing, Ministry of Agriculture and Rural Affairs/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Institute of Agro-Food Science and Technology, Shandong Academy of Agricultural Sciences, Jinan, China

    Jinyue Sun, Chao Liu & Qidong Ren

  6. College of Clinical and Basic Medicine of Shandong First Medical University, Jinan, China

    Jihong Lu

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All authors are involved in the creation of manuscripts by making specific contributions.

Corresponding authors

Correspondence to Pingping Hu or Jiandong Zhang.

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There are no conflicts of interest to report.

Ethical approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The retrospective study was approved by the Evaluation Committee of Shandong Provincial Qianfoshan Hospital prior to being performed (No. 2022-S607). Individual consent for this retrospective analysis was waived. Participating hospitals notified and agreed to carry out research.

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Individual consent for this retrospective analysis was waived. Participating hospitals notified and agreed to carry out research.

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Mi, S., Yang, Y., Liu, X. et al. Effect of immune checkpoint inhibitors at different treatment time periods on prognosis of patients with extensive-stage small-cell lung cancer. Clin Transl Oncol (2024). https://doi.org/10.1007/s12094-024-03471-y

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