Inomata Minehiko, Takata Naoki, Seto Zenta, Murayama Nozomu, Tokui Kotaro, Okazawa Seisuke, Imanishi Shingo, Miwa Toshiro, Hayashi Ryuji, Matsui Shoko
First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan;
First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
In Vivo. 2025 Jan-Feb;39(1):467-472. doi: 10.21873/invivo.13850.
BACKGROUND/AIM: Chemoimmunotherapy has improved overall survival in patients with extensive small-cell lung cancer (SCLC). However, the backgrounds of patients enrolled in clinical trials tend to differ from those of patients treated in clinical practice, and the effectiveness of chemoimmunotherapy may be unclear in some populations, including patients with poor performance status. This study aimed to evaluate the effectiveness of chemoimmunotherapy for SCLC patients in clinical practice while focusing on several subgroups.
We retrospectively analyzed the data of SCLC patients who received chemoimmunotherapy or chemotherapy. The association between chemoimmunotherapy and overall survival was evaluated by adjusting for patient backgrounds using the Cox proportional hazards model, followed by a subset analysis.
The chemoimmunotherapy and chemotherapy groups included 43 and 71 patients, respectively. The Cox proportional hazards model showed that chemoimmunotherapy was significantly associated with improved overall survival (hazard ratio=0.47, 95% confidential interval=0.26-0.83). Furthermore, subgroup analysis showed that overall survival was significantly improved in patients with good performance status, lower neutrophil/lymphocyte ratio, and no liver metastases. However, overall survival with chemoimmunotherapy was similar to that with chemotherapy and was less than 12 months in patients with a poor performance status or higher neutrophil/lymphocyte ratio.
Chemoimmunotherapy was significantly associated with improved overall survival in clinical practice. However, the effectiveness was equivocal in SCLC patients with a poor performance status or higher neutrophil/lymphocyte ratio.
背景/目的：化疗免疫疗法已改善了广泛期小细胞肺癌（SCLC）患者的总生存期。然而，参与临床试验的患者背景往往与临床实践中接受治疗的患者不同，化疗免疫疗法在某些人群中的有效性可能并不明确，包括体能状态较差的患者。本研究旨在评估化疗免疫疗法在临床实践中对SCLC患者的有效性，同时关注几个亚组。
我们回顾性分析了接受化疗免疫疗法或化疗的SCLC患者的数据。使用Cox比例风险模型对患者背景进行校正后，评估化疗免疫疗法与总生存期之间的关联，随后进行亚组分析。
化疗免疫疗法组和化疗组分别包括43例和71例患者。Cox比例风险模型显示，化疗免疫疗法与总生存期改善显著相关（风险比=0.47，95%置信区间=0.26-0.83）。此外，亚组分析显示，体能状态良好、中性粒细胞/淋巴细胞比值较低且无肝转移的患者总生存期显著改善。然而，化疗免疫疗法的总生存期与化疗相似，体能状态较差或中性粒细胞/淋巴细胞比值较高的患者总生存期不足12个月。
在临床实践中，化疗免疫疗法与总生存期改善显著相关。然而，对于体能状态较差或中性粒细胞/淋巴细胞比值较高的SCLC患者，其有效性并不明确。
