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Efficacy of Tyrosine Kinase Inhibitors in Primary Driver-Gene-Positive Combined Small-Cell Lung Cancer: A
Zheng Shi1, Jingwen Wei1, Wei Sun1
1Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou, China; Wenzhou Medical University, Wenzhou, China.
Background:
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.
Methods:
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.
Results:
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%).
Conclusions:
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.
Insights
Targeted therapy, particularly combination therapy, shows promise for driver-gene-positive combined small-cell lung cancer (c-SCLC). This approach improved progression-free survival compared to chemotherapy alone in a small patient cohort.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Combined small-cell lung cancer (c-SCLC) is a rare subtype often co-occurring with adenocarcinoma.
- Specific gene mutations in c-SCLC present potential targets for therapy.
- The efficacy of targeted treatments in c-SCLC remains uncertain due to rarity and testing challenges.
Purpose of the Study:
- To evaluate the efficacy of different treatment regimens in gene mutation-positive c-SCLC patients.
- To compare outcomes between chemotherapy, targeted monotherapy, and targeted combination therapy.
Main Methods:
- Retrospective analysis of 31 c-SCLC patients with gene mutations.
- Grouping patients based on first-line treatment: chemotherapy, targeted monotherapy, or targeted combination therapy.
- Survival analysis using Kaplan-Meier method and Log Rank test.
Main Results:
- Targeted combination therapy showed the highest overall response rate (62.5%) and disease control rate (100%).
- Median progression-free survival was significantly longer in the combination therapy group (7.93 months) compared to chemotherapy (4.0 months).
- Targeted therapies, as a whole, demonstrated a 54.5% ORR and 90.9% DCR with a median PFS of 5.87 months.
Conclusions:
- Tyrosine kinase inhibitors (TKIs) demonstrate encouraging efficacy in driver-gene-positive c-SCLC.
- Targeted combination therapy appears superior to chemotherapy and monotherapy for this patient group.
- Further research is warranted to optimize targeted treatment strategies for c-SCLC.
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