Kang Wenwen, Cheng Jing, Pan Luyun, Zhan Ping, Liu Hongbing, Lv Tangfeng, Han Hedong, Song Yong
Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Front Oncol. 2024 Oct 18;14:1334957. doi: 10.3389/fonc.2024.1334957. eCollection 2024.
Differences in clinicopathological characteristics of extensive-stage small cell lung cancer (ES-SCLC) patients may influence the immune response. This study aims to evaluate the heterogeneity of response to first-line chemoimmunotherapy between subgroups in ES-SCLC to screen out suitable populations.
We searched the PubMed, EMBASE, and Cochrane Library databases from inception to December 3, 2022 for randomized controlled trials (RCTs) of ES-SCLC chemoimmunotherapy. We also reviewed main conferences from January 1, 2021 to October 1, 2023. A trial-specific hazard ratio (HR) ratio for each subgroup was calculated, and these ratios were then pooled using the deft approach.
A total of 9 RCTs with 4099 patients were finally included. The pooled ratios were 0.92 (95% CI = 0.77 to 1.09) for OS-HRs and 0.79 (95% CI = 0.55 to 1.13) for PFS-HRs in women versus men. The pooled ratios of OS-HRs and PFS-HRs in patients with positive versus negative PD-L1 expression were 1.26 (95% CI = 0.91 to 1.73) and 1.08 (95% CI = 0.77 to 1.52), respectively. The pooled ratios of OS-HRs and PFS-HRs in patients without versus with brain metastasis were 0.77 (95% CI = 0.59 to 1.01) and 0.71 (95% CI = 0.44 to 1.12). No statistically significant differences were also found in terms of subgroups for age, liver metastasis, smoking status, ECOG PS, LDH level, type of platinum salt and race.
Women or patients with negative PD-L1 expression or with LDH ≤ ULN or without brain metastasis tend to benefit more from first-line chemoimmunotherapy in ES-SCLC. More trials are needed to prospectively validate the therapeutic heterogeneity among clinicopathological characteristics.
https://inplasy.com/inplasy-2023-3-0064/ identifier, INPLASY202330064.
广泛期小细胞肺癌（ES-SCLC）患者的临床病理特征差异可能影响免疫反应。本研究旨在评估ES-SCLC各亚组对一线化疗免疫治疗反应的异质性，以筛选出合适的人群。
我们检索了从数据库建立至2022年12月3日的PubMed、EMBASE和Cochrane图书馆数据库，查找ES-SCLC化疗免疫治疗的随机对照试验（RCT）。我们还回顾了2021年1月1日至2023年10月1日的主要会议。计算每个亚组的试验特异性风险比（HR），然后使用deft方法汇总这些比值。
最终纳入9项RCT，共4099例患者。女性与男性的总生存HR（OS-HRs）合并比值为0.92（95%CI=0.77至1.09），无进展生存HR（PFS-HRs）合并比值为0.79（95%CI=0.55至1.13）。PD-L1表达阳性与阴性患者的OS-HRs和PFS-HRs合并比值分别为1.26（95%CI=0.91至1.73）和1.08（95%CI=0.77至1.52）。无脑转移与有脑转移患者的OS-HRs和PFS-HRs合并比值分别为0.77（95%CI=0.59至1.01）和0.71（95%CI=0.44至1.12）。在年龄、肝转移、吸烟状态、ECOG体力状态、乳酸脱氢酶（LDH）水平、铂盐类型和种族等亚组方面，也未发现统计学上的显著差异。
女性、PD-L1表达阴性的患者、LDH≤正常上限（ULN）的患者或无脑转移的患者在ES-SCLC一线化疗免疫治疗中可能获益更多。需要更多试验来前瞻性验证临床病理特征之间的治疗异质性。
https://inplasy.com/inplasy-2023-3-0064/标识符，INPLASY202330064。
