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Real-world analysis of immunochemotherapy in recurrent small-cell lung cancer: opportunities for second-line
Yanrong Guo1, Songyan Han1, Qinxiang Guo1
1Department of Respiratory Medicine, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
Background:
Small-cell lung cancer (SCLC) has limited therapeutic options beyond first-line treatment, and the efficacy of PD-1/PD-L1-based immunotherapy in this setting remains uncertain. This study evaluates the efficacy and safety of serplulimab-based immunochemotherapy as a second- or later-line treatment for SCLC.
Methods:
This retrospective, real-world study included 39 SCLC patients treated with post-initial serplulimab-based immunochemotherapy at Shanxi Provincial Cancer Hospital between May 2022 and November 2023. Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively. Cox analyses were conducted to explore factors associated with survival outcomes.
Results:
The median follow-up duration was 13.7 months. The OS was 12.00 months (95% CI: 6.87-not reached), and the median PFS was 4.07 months (95% CI: 3.07-7.17), with an objective response rate of 20.51%. Patients who underwent immunotherapy re-challenge showed numerically higher median OS (12.77 vs. 9.17 months) and PFS (5.93 vs. 3.87 months) than those without prior immunotherapy. Patients with an objective response to front-line therapy exhibited a trend toward improved median OS (not reached vs. 6.47 months) and PFS (5.93 vs. 3.17 months). Cox analysis identified ECOG PS of 2, elevated LDH, ProGrp, and NSE, and liver metastasis were associated with worse OS. The most common adverse events were thrombocytopenia, elevated ALT, and hypothyroidism, with a manageable safety profile.
Conclusion:
Second- or later-line serplulimab-based immunochemotherapy shows promising antitumor activity and survival benefits for SCLC, regardless of prior immunotherapy exposure. Although limited by sample size and retrospective design, these findings highlight the potential of immunotherapy combinations beyond first-line therapy.
Insights
Second-line serplulimab immunochemotherapy shows promise for small-cell lung cancer (SCLC) patients, offering survival benefits regardless of prior immunotherapy. This approach demonstrates potential for advanced SCLC treatment.
Area of Science:
- Oncology
- Immunotherapy
- Lung Cancer Research
Background:
- Small-cell lung cancer (SCLC) has limited treatment options beyond initial therapy.
- The role of PD-1/PD-L1 inhibitors in later-line SCLC treatment is not well-established.
Purpose of the Study:
- To evaluate the efficacy and safety of serplulimab-based immunochemotherapy as a second- or later-line treatment for SCLC.
- To identify factors influencing survival outcomes in SCLC patients receiving serplulimab.
Main Methods:
- Retrospective, real-world study of 39 SCLC patients treated with serplulimab-based immunochemotherapy.
- Data collected from May 2022 to November 2023 at Shanxi Provincial Cancer Hospital.
- Overall survival (OS) and progression-free survival (PFS) were primary and secondary endpoints, respectively; Cox analyses were performed.
Main Results:
- Median OS was 12.00 months and median PFS was 4.07 months, with an objective response rate of 20.51%.
- Patients receiving immunotherapy re-challenge showed improved OS and PFS compared to those without prior immunotherapy.
- Objective response to front-line therapy trended towards better OS and PFS; ECOG PS, LDH, ProGrp, NSE, and liver metastasis were associated with worse OS.
Conclusions:
- Serplulimab-based immunochemotherapy demonstrates promising antitumor activity and survival benefits in second- or later-line SCLC.
- The treatment appears effective regardless of prior immunotherapy exposure.
- While limited by sample size, findings support immunotherapy combinations beyond first-line SCLC therapy.
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