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A Retrospective Real-World Study: The Efficacy and Safety of Immune Checkpoint Inhibitors Combined with
Ruoxue Cai1, Shuyi Hu2, Feiyang Li2
1Department of Oncology, Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
Objective:
To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer (LS-SCLC). We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.
Methods:
We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) (Group A) and immunotherapy combined with CCRT/SCRT followed by immunotherapy (Group B), to assess the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Factors affecting prognosis were also explored using Cox analysis. The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.
Results:
The overall ORR was 55.93%. The overall DCR was 98.31%. The DCR was 100% in Group A and 96.61% in Group B. There was no statistical difference in ORR and DCR. The overall median PFS was 9.86 months (95% CI, 8.62-11.10), and the difference in median PFS between the two groups was statistically significant (8.94 vs. 11.89 months, p = 0.03). The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis. Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT. Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I + II + IIIA.
Conclusion:
We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT. Type 2 diabetes and TNM stage affect the survival prognosis. Patients with type 2 diabetes may benefit from immunotherapy combination treatments.
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