Li Ruyue, Zhang Huanle, Li Ying, Yao Xiujing, Dong Xue, Xu Yali, Li Yintao
School of Clinical Medicine, Shandong Second Medical University, Weifang, China.
Department of Radiotherapy, Suzhou Ninth People's Hospital, Suzhou, China.
Discov Oncol. 2025 Mar 14;16(1):316. doi: 10.1007/s12672-025-02071-8.
Patients with advanced pulmonary large-cell neuroendocrine carcinoma (LCNEC) have a progressive clinical course and poor prognosis, and effective treatment options remain limited. This study assessed the efficacy and safety of immunotherapy plus chemotherapy for advanced LCNEC.
We retrospectively collected medical records of patients with advanced LCNEC who attended Shandong Cancer Hospital from January 2018 to December 2022. Patients were divided into two groups based on their previous treatment regimen: immunotherapy plus chemotherapy and chemotherapy alone. Kaplan-Meier survival curves and Cox regression models were used to evaluate the clinical efficacy of different treatment regimens.
The median follow-up was 29.33 months (95% confidence interval [CI]: 24.04-not reached). The median overall survival (OS) was 15.01 months (95% CI: 11.99-26.31) and 7.19 months (95% CI: 5.15-10.57) in the immunotherapy plus chemotherapy and chemotherapy groups, respectively (P = 0.001). Following propensity score matching, the median OS was 17.41 months (95% CI: 11.99-29.20) and 5.88 months (95% CI: 4.50-11.53) in the immunotherapy plus chemotherapy and chemotherapy groups, respectively. The median progression-free survival was 6.70 months (95% CI: 5.48-13.27) and 3.12 months (95% CI: 2.52-4.20) in the immunotherapy plus chemotherapy and chemotherapy groups, respectively. We also found that increasing age may contribute to poorer prognosis in patients with advanced LCNEC (P < 0.05).
Immunotherapy plus chemotherapy significantly improved OS compared with chemotherapy in LCNEC, with a tolerable safety profile without life-threatening adverse events. Immunotherapy plus chemotherapy may be an effective treatment option for patients with advanced LCNEC.
晚期肺大细胞神经内分泌癌（LCNEC）患者临床病程呈进行性发展，预后较差，有效的治疗选择仍然有限。本研究评估了免疫治疗联合化疗用于晚期LCNEC的疗效和安全性。
我们回顾性收集了2018年1月至2022年12月在山东省肿瘤医院就诊的晚期LCNEC患者的病历。根据既往治疗方案将患者分为两组：免疫治疗联合化疗组和单纯化疗组。采用Kaplan-Meier生存曲线和Cox回归模型评估不同治疗方案的临床疗效。
中位随访时间为29.33个月（95%置信区间[CI]：24.04 - 未达到）。免疫治疗联合化疗组和单纯化疗组的中位总生存期（OS）分别为15.01个月（95%CI：11.99 - 26.31）和7.19个月（95%CI：5.15 - 10.57）（P = 0.001）。倾向评分匹配后，免疫治疗联合化疗组和单纯化疗组的中位OS分别为17.41个月（95%CI：11.99 - 29.20）和5.88个月（95%CI：4.50 - 11.53）。免疫治疗联合化疗组和单纯化疗组的中位无进展生存期分别为6.70个月（95%CI：5.48 - 13.27）和3.12个月（95%CI：2.52 - 4.20）。我们还发现，年龄增加可能导致晚期LCNEC患者预后更差（P < 0.05）。
与单纯化疗相比，免疫治疗联合化疗显著改善了LCNEC患者的总生存期，安全性可耐受，无危及生命的不良事件。免疫治疗联合化疗可能是晚期LCNEC患者的一种有效治疗选择。
