Tian Jizheng, Sui Lili, Wang Hong, Chen Xiaoyan
Department of Oncology, Beijing Shunyi District Hospital, Shunyi Teaching Hospital of Capital Medical University, Beijing, China.
Front Oncol. 2023 Jul 4;13:1180735. doi: 10.3389/fonc.2023.1180735. eCollection 2023.
Small cell lung cancer (SCLC) constitutes 15% of all lung cancer cases, with a comparatively low survival rate. The advent of immune checkpoint inhibitors (ICIs) has provided new alternatives for treating SCLC. However, the effectiveness of camrelizumab in the treatment of SCLC remains unclear. This retrospective case series was designed to investigate the efficacy and safety of camrelizumab in SCLC patients.
The study enrolled SCLC patients recorded as having received more than one cycle of camrelizumab in the electronic medical record system. Data related to clinical and survival times were collected and statistically analyzed.
From August 2019 to December 2021, the study enrolled 12 SCLC patients. The objective response rate was 41.7% (95% confidence interval [CI]: 15.2%-72.3%). The disease control rate was 83.3% (95% CI: 51.6%-97.9%). The median progression-free survival (PFS) for all patients was 4.0 months. Notably, the median PFS of patients in third- or post-third-line subgroups was 7 months (95% CI: 1.12-12.88 months). The median overall survival (OS) for all eligible patients was 10.0 months (95% CI: 7.35-12.65 months), with a 1-year survival rate of 25%. Notably, the OS of patients treated with third- or post-third-line therapy was 5-34 months, with a 1-year survival rate of 75%. The two most prevalent non-hematological adverse events associated with the immune response were pneumonitis (44.4%) and reactive cutaneous capillary endothelial proliferation (44.4%). One patient experienced an exacerbation of preexisting diabetes and reached grade 3 hyperglycemia. There were no grade 4/5 immune-related adverse events.
This case series highlights the potential benefits and safety concerns of camrelizumab in SCLC patients. These findings suggest a possible strategy for third- and post-third-line treatments of SCLC. However, the conclusion is limited due to the study's retrospective nature and small sample size. Therefore, large-scale randomized controlled studies are needed to determine its efficacy.
小细胞肺癌（SCLC）占所有肺癌病例的15%，生存率相对较低。免疫检查点抑制剂（ICI）的出现为SCLC的治疗提供了新的选择。然而，卡瑞利珠单抗治疗SCLC的有效性仍不明确。本回顾性病例系列旨在研究卡瑞利珠单抗治疗SCLC患者的疗效和安全性。
该研究纳入了电子病历系统中记录接受过一个以上周期卡瑞利珠单抗治疗的SCLC患者。收集并统计分析与临床和生存时间相关的数据。
2019年8月至2021年12月，该研究纳入了12例SCLC患者。客观缓解率为41.7%（95%置信区间[CI]：15.2%-72.3%）。疾病控制率为83.3%（95%CI：51.6%-97.9%）。所有患者的中位无进展生存期（PFS）为4.0个月。值得注意的是，三线或三线后亚组患者的中位PFS为7个月（95%CI：1.12-12.88个月）。所有符合条件患者的中位总生存期（OS）为10.0个月（95%CI：7.35-12.65个月），1年生存率为25%。值得注意的是，接受三线或三线后治疗的患者的OS为5-34个月，1年生存率为75%。与免疫反应相关的两种最常见的非血液学不良事件是肺炎（44.4%）和反应性皮肤毛细血管内皮增生（44.4%）。1例患者既往糖尿病加重，达到3级高血糖。无4/5级免疫相关不良事件。
本病例系列突出了卡瑞利珠单抗在SCLC患者中的潜在益处和安全问题。这些发现提示了一种可能的SCLC三线及三线后治疗策略。然而，由于该研究的回顾性性质和小样本量，结论有限。因此，需要大规模随机对照研究来确定其疗效。
