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阿特珠单抗联合铂类双药化疗:广泛期小细胞肺癌患者的生存结局评估。

Atezolizumab addition to platinum doublet: evaluating survival outcomes for patients with extensive disease small cell lung cancer.

机构信息

Department of Pulmonology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan.

Respiratory Disease Center, Yokohama City University Medical Center, 4-59 Urafune-Cho, Minami-Ku, Yokohama, Japan.

出版信息

J Cancer Res Clin Oncol. 2023 Dec;149(19):17419-17426. doi: 10.1007/s00432-023-05457-9. Epub 2023 Oct 25.

Abstract

BACKGROUND

The efficacy of adding atezolizumab to the platinum doublet regimen for extensive disease small cell lung cancer (ED-SCLC) remains marginally limited.

METHODS

We retrospectively assessed the real-world efficacy and safety of atezolizumab in addition to carboplatin and etoposide (EP + A), versus carboplatin and etoposide (EP) alone in previously untreated ED-SCLC patients.

RESULTS

From a total of 99 patients, 46 were assigned to the EP + A group, and 53 to the EP group. No significant difference was observed in progression-free survival between the groups. However, the overall survival (OS) was significantly longer in the EP + A group (20.8 vs 12.1 months; HR: 0.52; p = 0.0127). Patients older than 70 years, male, with performance status 0-1, without liver metastasis, and low levels of C-reactive protein and neutrophil-lymphocyte ratio, experienced longer OS in the EP + A group compared to the EP group.

CONCLUSION

The addition of atezolizumab to the platinum doublet regimen significantly extended OS in ED-SCLC patients, particularly among certain subgroups, suggesting its potential value in personalized treatment strategies. Further investigation is warranted to validate these findings.

摘要

背景

在广泛期小细胞肺癌(ED-SCLC)中,添加阿替利珠单抗到铂类双药方案中的疗效仍然有限。

方法

我们回顾性评估了阿替利珠单抗联合卡铂和依托泊苷(EP+A)与单独使用卡铂和依托泊苷(EP)在未经治疗的 ED-SCLC 患者中的真实世界疗效和安全性。

结果

在总共 99 名患者中,46 名患者被分配到 EP+A 组,53 名患者被分配到 EP 组。两组之间无无进展生存期差异。然而,EP+A 组的总生存期(OS)明显更长(20.8 与 12.1 个月;HR:0.52;p=0.0127)。与 EP 组相比,年龄大于 70 岁、男性、表现状态 0-1、无肝转移以及 C 反应蛋白和中性粒细胞-淋巴细胞比值较低的患者,在 EP+A 组中 OS 更长。

结论

铂类双药方案中添加阿替利珠单抗显著延长了 ED-SCLC 患者的 OS,尤其是在某些亚组中,提示其在个体化治疗策略中具有潜在价值。需要进一步研究来验证这些发现。

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