KEY TAKEAWAYS
- The study aimed to investigate the efficacy and safety of 1L immunotherapy combined with chemo in treating patients with SCLC.
- Researchers concluded that Serplulimab combined with chemo shows promising efficacy and safety in treating SCLC; further investigation is ongoing.
The efficacy and safety of different immunosuppressants combined with chemotherapy (Chemo) in treating patients with small-cell lung cancer (SCLC) (extensive-disease SCLC, limited-disease SCLC, and relapsed SCLC) are still unknown, and there are no reports directly comparing the efficacy and safety of other immunotherapies.
Siyao Gong and the team aimed to compare the efficacy and safety of first-line (1L) immunotherapy combined with chemo in patients with SCLC.
They performed an inclusive analysis by searching Pubmed, Embase, Cochrane Library, CNKI, and Wanfang databases for relevant articles published from inception to November 11, 2020. The risk of bias in the included studies was assessed using the Cochrane risk-of-bias (RoB) tool. Multiple Bayesian network meta-analyses were conducted, and data analysis was performed using R Studio and STATA version 15.1.
The outcomes evaluated included overall survival (OS), progression-free survival (PFS), stability of response (SOR), duration of response (DOR), and adverse events of grade 3 or higher (AE grade≥3). A 95% confidence interval (CI) was provided for each estimate.
They included 16 RCT studies with 5898 patients. For OS, relative to chemotherapy (MD=-4.49; 95%CI [-7.97, -1.03]), durvalumab plus tremelimumab (MD=-4.62; 95%CI [-9.08, -0.11]), ipilimumab (MD=-4.26; 95%CI [-8.01, -0.3]) and nivolumab(MD=-5.66; 95%CI [-10.44, -1.11]) and nivolumab plus ipilimumab (MD=-4.56; 95%CI [-8.7, -0.1]), serplulimab can significantly increase the OS of SCLC patients. There was no significant difference between PFS, SOR, and DOR. Analysis of AE showed that different immunotherapy combined chemotherapy regimens were similar to single chemotherapy regarding the overall incidence of AE grade≥3.
However, after the cumulative ranking of the common symptoms of different adverse reactions, it was found that nivolumab ranked first in the occurrence probability of anemia (99.08%), fatigue (84.78%), and decreased appetite (89.66%), durvalumab was the most likely in nausea (75.4%). Pembrolizumab (76.24%) was most likely to cause pruritus. Chemotherapy combined with immunotherapy caused less diarrhea than chemotherapy alone (80.16%).
The study concluded that serplulimab combined with chemotherapy demonstrates promising efficacy and a manageable safety profile for SCLC. However, the evidence for this comparison is limited due to the scarcity of literature.
This study was sponsored by the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine, Central Guidance for Local Projects, National Natural Science Foundation of Sichuan Province, and National Natural Science Foundation of China.
Source: https://pubmed.ncbi.nlm.nih.gov/38694505/
Gong S, Li Q, Yu X, et al. (2024). “Efficacy and safety of different immunotherapies combined with chemotherapy as first-line therapy in patients with small cell lung cancer: a network meta-analysis.” Front Immunol. 2024 Apr 17;15:1362537. doi: 10.3389/fimmu.2024.1362537. PMID: 38694505; PMCID: PMC11061408.
