Hunting John C, Price Sarah N, Faucheux Andrew T, Olson Eric, Elko Catherine A, Quattlebaum Alexander, Ruiz Jimmy, Lycan Thomas William
Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Immunotherapy. 2025 Jan;17(1):19-24. doi: 10.1080/1750743X.2025.2456448. Epub 2025 Jan 23.
Prior research indicates a connection between immune-related adverse events (irAEs) and improved progression-free survival (PFS) and overall survival (OS) in non-small cell lung cancer. However, limited data exists for extensive stage small cell lung cancer (ES-SCLC).
This study included all ES-SCLC patients who received at least one dose of an immune checkpoint inhibitor between 2 January 2011 and 4 July 2022 using a large retrospective registry from a single institution. PFS and OS were right-censored at the date of last follow-up and were estimated using the Kaplan-Meier method. Differences in PFS and OS between irAE groups were assessed using Cox proportional hazards models.
Among 245 patients with ES-SCLC; 56 (23%) experienced irAEs, 24 (42.9%) of which were high-grade (3-4). High-grade irAEs occurred at a median of 1.2 months (interquartile range [IQR] 0.45-2.5), while low-grade irAE occurred at 2.8 months (1.3-5.2). PFS was significantly longer among any irAE vs none (HR = 0.49; [95%CI 0.32-0.77]) as was OS (HR = 0.49; [95%CI 0.34-0.72]).
In ES-SCLC patients treated with immunotherapy, those who experienced any irAE demonstrated a two-fold increase in both PFS and OS compared to those without an irAE. This is consistent with other tumor primaries.
先前的研究表明，免疫相关不良事件（irAE）与非小细胞肺癌患者无进展生存期（PFS）和总生存期（OS）的改善之间存在关联。然而，广泛期小细胞肺癌（ES-SCLC）的数据有限。
本研究纳入了2011年1月2日至2022年7月4日期间在单一机构使用大型回顾性登记系统接受至少一剂免疫检查点抑制剂治疗的所有ES-SCLC患者。PFS和OS在最后一次随访日期进行右删失，并使用Kaplan-Meier方法进行估计。使用Cox比例风险模型评估irAE组之间PFS和OS的差异。
在245例ES-SCLC患者中，56例（23%）发生了irAE，其中24例（42.9%）为高级别（3-4级）。高级别irAE发生的中位时间为1.2个月（四分位间距[IQR]0.45-2.5），而低级别irAE发生的时间为2.8个月（1.3-5.2）。发生任何irAE的患者的PFS显著长于未发生irAE的患者（HR = 0.49；[95%CI 0.32-0.77]），OS也是如此（HR = 0.49；[95%CI 0.34-0.72]）。
在接受免疫治疗的ES-SCLC患者中，发生任何irAE的患者的PFS和OS均比未发生irAE的患者增加了两倍。这与其他原发性肿瘤一致。
