Zhang Qichen, Han Xiaojuan, Liu Jiayi, Qiao Hui
The First Clinical Medical College of Lanzhou University, Lanzhou, China.
Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, China.
Cancer Rep (Hoboken). 2025 Jan;8(1):e70081. doi: 10.1002/cnr2.70081.
This study aims to evaluate the efficacy and safety of PD-1/PD-L1 inhibitors in treating small-cell lung cancer (SCLC) and determine the role of PD-1 monoclonal antibodies in improving patient outcomes.
A retrospective analysis was performed on 37 SCLC patients who received PD-1 or PD-L1 inhibitors along with chemotherapy at the First Hospital of Lanzhou University between June 2018 and June 2023. Treatment effectiveness was measured by overall response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS), utilizing chi-square and T-tests, along with Kaplan-Meier and log-rank analyses.
In the PD-L1 group, 16 patients achieved partial or complete response, versus 12 in the PD-1 group, though the difference in the ORR was not statistically significant (50.0% vs. 36.8%, p = 0.308). Median survival times were 21.0 months for PD-L1 and 17.0 months for PD-1, with no statistically meaningful difference (p = 0.180). Adverse effects were comparable between the groups in terms of thyroid function (p = 0.898), but bone marrow suppression and gastrointestinal reactions were significantly less severe in the PD-L1 group (p = 0.047 and p = 0.002).
Immunotherapy combined with chemotherapy offers significant benefits for advanced SCLC patients, irrespective of the type of inhibitor used. Despite the higher incidence of adverse reactions with PD-1 inhibitors, they remain a viable option, particularly when PD-L1 inhibitors are not available, due to their manageable safety profile and effective response.
本研究旨在评估PD-1/PD-L1抑制剂治疗小细胞肺癌（SCLC）的疗效和安全性，并确定PD-1单克隆抗体在改善患者预后中的作用。
对2018年6月至2023年6月期间在兰州大学第一医院接受PD-1或PD-L1抑制剂联合化疗的37例SCLC患者进行回顾性分析。通过总缓解率（ORR）、疾病控制率（DCR）、总生存期（OS）和无进展生存期（PFS）来衡量治疗效果，采用卡方检验和T检验以及Kaplan-Meier和对数秩分析。
在PD-L1组中，16例患者达到部分或完全缓解，PD-1组为12例，尽管ORR差异无统计学意义（50.0%对36.8%，p = 0.308）。PD-L1组的中位生存时间为21.0个月，PD-1组为17.0个月，差异无统计学意义（p = 0.180）。两组在甲状腺功能方面的不良反应相当（p = 0.898），但PD-L1组的骨髓抑制和胃肠道反应明显较轻（p = 0.047和p = 0.002）。
免疫疗法联合化疗对晚期SCLC患者具有显著益处，无论使用何种抑制剂类型。尽管PD-1抑制剂的不良反应发生率较高，但由于其安全性可控且反应有效，它们仍然是一个可行的选择，尤其是在没有PD-L1抑制剂的情况下。
