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Multicenter Study
. 2025 Jul 1;25(1):1136.
doi: 10.1186/s12885-025-14524-y.

Efficacy and safety of first-line chemoimmunotherapy in young patients with extensive-stage small cell lung cancer: a multicenter retrospective study

Lijuan Zhao #  1   2 , Qi Xiong #  1 , Yaping Long #  3 , Haiming Hu  4 , Zhouhuan Dong  5 , Fengwei Zhu  5 , Jun Zhao  6 , Bo Yang  7 , Jingzhi Guan  8
Affiliations
Multicenter Study

Efficacy and safety of first-line chemoimmunotherapy in young patients with extensive-stage small cell lung cancer: a multicenter retrospective study

Lijuan Zhao et al. BMC Cancer. .

Abstract

Objectives: Chemoimmunotherapy is the first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). This study aims to evaluate the survival outcomes and safety of chemoimmunotherapy in young patients with ES-SCLC.

Patients and methods: Patients with pathologically or cytologically confirmed ES-SCLC from three centers and divided into two age groups: young (aged ≤ 45 years) and control (aged > 45 to ≤ 75 years) between January 2015 and December 2023. We assessed progression-free survival (PFS), overall survival (OS), and safety between the two age groups.

Results: Of the whole 347 patients, 59 were in the young group, while 288 were in the control group. The young group exhibited poorer PFS (median, 4.67 vs. 5.40 months, p < 0.001) and OS (median, 13.7 vs. 14.4 months, p = 0.028) compared with the control group, particularly in the context of chemoimmunotherapy [PFS (median, 4.50 vs. 5.57 months; p = 0.002), OS (median, 13.20 vs. 15.33 months; p = 0.012), respectively]. Additionally, in the young group, chemoimmunotherapy showed similar PFS (median, 4.50 vs. 5.75 months; p = 0.501) and OS (median, 13.20 vs. 13.70 months; p = 0.508) compared to chemotherapy. Moreover, the young group had a higher incidence of immune-related adverse events (irAEs) (30.51% vs. 11.46%, p < 0.001) and hematologic toxicity, including thrombocytopenia (25.42% vs. 14.24%, p = 0.033).

Conclusions: The young group had poorer survival outcomes and chemoimmunotherapy may not provide a survival benefit in young patients, as evidenced by similar PFS and OS compared to chemotherapy. Additionally, the young group also experienced a higher incidence of immune-related adverse events (irAEs) and hematologic toxicity.

Keywords: Adults; Chemoimmunotherapy; Drug-Related side effects and adverse reactions; Extensive-stage small cell lung cancer; Older adults.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by Ethics Committee of PLA General Hospital and was conducted strictly according to the principles of the Declaration of Helsinki. The need for informed consent was waived by Ethics Committee of PLA General Hospital because of the retrospective nature of the study and the use of anonymized data for analysis. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Workflow of this study. Abbreviations: SCLC, small cell lung cancer; LS-SCLC, limited–stage small cell lung cancer; ES-SCLC, extensive-stage small cell lung cancer; Young Group, ES–SCLC patients aged ≤ 45 years old; Control Group, ES-SCLC patients aged > 45 to ≤ 75 years old
Fig. 2
Fig. 2
Kaplan-Meier curves of (A) progression-free survival (PFS) and (B) overall survival (OS) in the entire ES-SCLC patients. Abbreviations: Young Group, “ES-SCLC patients aged ≤ 45 years old; Control Group, ES-SCLC patients aged > 45 to ≤ 75 years old; mPFS, median progression-free survival; mOS, median overall survival
Fig. 3
Fig. 3
Age-stratified Kaplan-Meier curves of (A) PFS and (B) OS for chemotherapy, and (C) PFS and (D) OS for chemoimmunotherapy in Young group and Control group. Abbreviations: Young Group, “ES-SCLC patients aged ≤ 45 years old; Control Group, ES-SCLC patients aged > 45 to ≤ 75 years old; mPFS, median progression-free survival; mOS, median overall survival
Fig. 4
Fig. 4
Kaplan-Meier curves of (A) progression-free survival (PFS) and (B) overall survival (OS) in the Young Group. Abbreviations: mPFS, median progression-free survival; mOS, median overall survival
Fig. 5
Fig. 5
Stratified Analysis for Assessing Chemoimmunotherapy efficacy in (A) progression–free survival (PFS) and (B) overall survival (OS). Abbreviations: Young group, “ES-SCLC patients aged ≤ 45 years old; Control group, ES-SCLC patients aged > 45 to ≤ 75 years old; PFS, progression-free survival; OS, overall survival; HR, hazard ratios; 95% CI, 95% confidence intervals
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References

    1. van Meerbeeck JP, et al. Small-cell lung cancer. Lancet (London England). 2011;378(9804):1741–55. - PubMed
    1. Siegel RL, et al. Cancer Stat 2021 CA: cancer J Clin. 2021;71(1):7–33. - PubMed
    1. Sung H, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2021;71(3):209–49. - PubMed
    1. Horn L, et al. First-Line Atezolizumab plus chemotherapy in Extensive-Stage Small-Cell lung Cancer. N Engl J Med. 2018;379(23):2220–9. - PubMed
    1. Paz-Ares L, et al. Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet (London England). 2019;394(10212):1929–39. - PubMed

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