Zhang Baishen, Chen Jing, Yu Hui, Li Meichen, Chen Likun
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China.
Transl Lung Cancer Res. 2024 Oct 31;13(10):2479-2490. doi: 10.21037/tlcr-24-335. Epub 2024 Oct 28.
Brain metastases (BM) are highly prevalent and associated with a poor prognosis in patients with small cell lung cancer (SCLC). However, the evidence regarding the efficacy of immune checkpoint inhibitors (ICIs) in combination with chemotherapy for patients with SCLC and BM remains limited. Therefore, the objective of this study is to evaluate whether the addition of ICIs confers survival benefits for patients with SCLC and BM.
This retrospective study enrolled patients with SCLC and BM at the Sun Yat-sen University Cancer Center between January 2018 and December 2022. Clinical characteristics were extracted from medical records. Depending on whether ICIs were added to the first-line treatment, the patients were categorized into the chemotherapy group and the chemoimmunotherapy group. The efficacy of these two treatment approaches was analyzed and compared.
A total of 165 patients were enrolled, with 85 in the chemotherapy group and 80 in the chemoimmunotherapy group. The chemoimmunotherapy group showed a tendency towards prolonged intracranial [6.6 . 5.9 months, hazard ratio (HR) =0.77; P=0.14] and extracranial (6.9 . 6.5 months, HR =0.73; P=0.12) progression-free survival (PFS) and overall survival (OS) (15.6 . 14.5 months, HR =0.98; P=0.93) compared to the chemotherapy group. Cox regression analysis identified liver metastases and local treatment for BM as independent prognostic factors for OS in patients. Furthermore, the chemotherapy group and the chemoimmunotherapy group demonstrated similar patterns of initial disease progression.
Adding ICIs to chemotherapy confers modest survival benefits in patients with SCLC and BM.
脑转移（BM）在小细胞肺癌（SCLC）患者中非常普遍，且与预后不良相关。然而，关于免疫检查点抑制剂（ICI）联合化疗治疗SCLC合并BM患者疗效的证据仍然有限。因此，本研究的目的是评估添加ICI是否能为SCLC合并BM患者带来生存益处。
本回顾性研究纳入了2018年1月至2022年12月期间在中山大学肿瘤防治中心就诊的SCLC合并BM患者。从病历中提取临床特征。根据一线治疗是否添加ICI，将患者分为化疗组和化疗免疫治疗组。分析并比较这两种治疗方法的疗效。
共纳入165例患者，化疗组85例，化疗免疫治疗组80例。与化疗组相比，化疗免疫治疗组的颅内无进展生存期（PFS）[6.6对5.9个月，风险比（HR）=0.77；P=0.14]、颅外PFS（6.9对6.5个月，HR =0.73；P=0.12）和总生存期（OS）（15.6对14.5个月，HR =0.98；P=0.93）有延长的趋势。Cox回归分析确定肝转移和BM的局部治疗是患者OS的独立预后因素。此外，化疗组和化疗免疫治疗组的初始疾病进展模式相似。
化疗中添加ICI可为SCLC合并BM患者带来适度的生存益处。
