AI Article Synopsis
- The study aims to assess how effective first-line treatments using PD-(L)1 blockade are in patients with extensive-stage small-cell lung cancer (ES-SCLC), focusing on those with and without liver metastases (LM).
- Through a network meta-analysis of seven randomized controlled trials involving 3658 patients, the study compares the outcomes of chemo-immunotherapy (CIT) and chemotherapy (CT) based on overall survival (OS) and progression-free survival (PFS).
- Results indicate that for patients with LM, the combination of anti-PD-1 and CT is the most effective treatment, while for those without LM, the best outcomes are seen with a regimen combining anti-angiogenesis, PD-L1 blockade, and
Article Abstract
Purpose: To compare the efficacy of first-line regimens based on programmed cell death (or ligand) [PD-(L)1] blockade in extensive-stage small-cell lung cancer (ES-SCLC) patients with or without liver metastases (LM), and to identify optimal treatment strategies.
Methods: Network meta-analysis of randomized controlled trials (RCTs) comparing chemo-immunotherapy (CIT) and chemotherapy (CT) in ES-SCLC patients stratified by LM. Overall survival (OS) and progression-free survival (PFS) were evaluated using hazard ratios (HRs) and 95% confidence intervals (CIs).
Results: Seven RCTs involving 3658 ES-SCLC patients (1243 with LM, 2415 without LM) were analyzed. For patients with LM, the combination therapies of anti-PD-1 + CT (HR, 0.67; 95% CI, 0.54%-0.82%; p < 0.001) and anti-PD-L1 + CT + anti-angiogenesis (HR, 0.84; 95% CI, 0.71%-0.99%; p = 0.042) demonstrated superior efficacy in prolonging OS compared to CT alone. The anti-PD-1 + CT regimen had the highest cumulative probability of 91.6% for extending OS in patients with LM. For patients without LM, all CIT regimens resulted in improved OS compared to CT alone, with the regimen of anti-angiogenesis + anti-PD-L1 + CT ranking first and having the highest cumulative probability of 95.5% for prolonging OS.
Conclusions: CIT is effective for ES-SCLC patients regardless of LM status. For patients with LM, PD-1 blockade combined with CT is the best option. For patients without LM, the most beneficial regimen is the combination of anti-angiogenesis, PD-L1 blockade, and CT.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447196 | PMC |
| http://dx.doi.org/10.1002/cam4.70256 | DOI Listing |
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