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Related Experiment Video

Updated: Apr 12, 2026

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
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Real-World Evidence of Treatment Outcomes in Small Cell Lung Cancer: A Bayesian Mixed Effects and Competitive Risk

Luca Marzano1, Asaf Dan2,3, Adam S Darwich1

  • 1KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Stockholm, 141 57, Sweden, 46 730647775.

JMIR Cancer
|April 10, 2026
PubMed
Summary

This study found that individualized dosing strategies for first-line small cell lung cancer (SCLC) therapy may improve outcomes. Real-world data analysis revealed factors influencing adverse events and survival in SCLC patients.

Keywords:
SCLCadverse effectschemotherapyreal-world datareal-world evidencesmall cell lung cancersurvivaltoxicity

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Area of Science:

  • Oncology
  • Clinical Research
  • Statistical Modeling

Background:

  • Small cell lung cancer (SCLC) presents treatment challenges including rapid progression and chemoresistance.
  • Real-world data (RWD) analyses are crucial for understanding intermediate events and treatment processes in SCLC.
  • Discrepancies exist between clinical trial outcomes and RWD for SCLC patients.

Purpose of the Study:

  • To apply advanced statistical methods to longitudinal SCLC data.
  • To identify factors influencing the risk of adverse events (AEs) and survival in SCLC patients.
  • To analyze treatment pathways and outcomes in a real-world SCLC cohort.

Main Methods:

  • Data-driven modeling of treatment pathways for 421 SCLC patients (2016-2022).
  • Bayesian mixed effects modeling to assess the impact of dose adjustment on AEs, including neutropenia.
  • Competitive risk models to explore factors affecting performance status deterioration and early chemotherapy discontinuation.

Main Results:

  • Neutropenia was associated with longer overall survival (HR 0.70).
  • Higher etoposide doses correlated with increased risk of AEs (OR 5.97) and neutropenia (OR 3.55).
  • Male patients showed fewer AEs and better first-line response than females (csHR 0.51).

Conclusions:

  • Individualized dosing strategies for first-line SCLC therapy are recommended.
  • Assessing the risk-benefit of treating specific patient subgroups, especially those on second-line therapy, is important.
  • Real-world data is valuable for studying therapy response and risk-benefit in underrepresented patient groups.