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Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
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Systematic review and network meta-analysis: evaluation of systemic therapies for platinum refractory or resistant

Rahul K Desai1, Elena J Zhou2, Kelvin K W Chan3

  • 1Sunnybrook Research Institute, Toronto, ON, Canada; Faculty of Health, University of Waterloo, Waterloo, Canada.

Lung Cancer (Amsterdam, Netherlands)
|November 6, 2025
PubMed
Abstract

Insights

Tarlatamab demonstrates superior overall survival and safety in platinum-refractory/resistant small cell lung cancer (SCLC). This network meta-analysis suggests tarlatamab as a preferred therapy option for patients with advanced SCLC.

Area of Science:

  • Oncology
  • Clinical Trials
  • Meta-Analysis

Background:

  • Platinum-refractory/resistant small cell lung cancer (SCLC) has a poor prognosis and limited treatment options.
  • Standard chemotherapy offers limited efficacy in this patient population.
  • Recent trials explored immunotherapy and targeted therapies, including tarlatamab.

Purpose of the Study:

  • To conduct a network meta-analysis comparing systemic therapies for platinum-refractory/resistant SCLC.
  • To evaluate overall survival (OS), progression-free survival (PFS), and safety profiles.
  • To rank treatments based on efficacy and safety.

Main Methods:

  • Systematic search of phase III randomized controlled trials (RCTs) up to June 2025.
  • Inclusion of studies evaluating systemic therapies in platinum r/r SCLC.
  • Indirect comparisons using Markov Chain Monte Carlo methods and SUCRA probabilities for treatment ranking.

Main Results:

  • Six phase III RCTs were included in the analysis.
  • Tarlatamab and nivolumab showed improved OS compared to other treatments.
  • Tarlatamab demonstrated the highest ranking for OS (SUCRA 0.96) and superior safety.

Conclusions:

  • Tarlatamab offers the most favorable outcomes in platinum-refractory/resistant SCLC.
  • Tarlatamab should be considered a preferred therapy for this indication.
  • The findings support tarlatamab's efficacy and safety profile in advanced SCLC.
Keywords:
Advanced diseaseChemotherapyImmunotherapyMeta-analysisOat cell lung cancerSmall cell cancer of the lungSmall cell lung cancer (SCLC)Small cell lung carcinomaTaralatamabTargeted therapy

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