The current first-line standard treatment for advanced small cell lung cancer (SCLC) is a combination of chemotherapy and immunotherapy. However, few efficacy data are available in a real-life settings, including frail patients. The aim of this study is to describe the real-life efficacy of chemoimmunotherapy in an unselected SCLC population. We conducted a retrospective multicenter study, which compared two cohorts of patients with treatment-naive metastatic SCLC treated in six academic centers in the Greater Paris area. Cohort 1 included patients treated with chemotherapy between January 2017 and December 2018, and cohort 2 included patients treated with chemoimmunotherapy between January 2019 and December 2020. A total of 153 consecutive patients were included (cohort 1: n = 96; cohort 2: n = 57). Clinical characteristics were similar between the two cohorts. Overall survival (OS) was statistically higher in cohort 2 (median survival 15.47 months) than in cohort 1 (median survival 9.5 months) (p = 0.0001). OS for patients with a performance status ≥2 and for patients ≥70 years old was not statistically different between the two cohorts. Chemoimmunotherapy efficacy was better compared to chemotherapy alone in case of brain or liver metastases. In conclusion, the combination of chemoimmunotherapy in metastatic SCLC appears to provide a real-life OS benefit. Dedicated clinical trials are needed to test this strategy in patients with impaired performance status or advanced age.
目前晚期小细胞肺癌（SCLC）的一线标准治疗方案为化疗联合免疫治疗。然而，在真实世界临床实践中（包括体能状态较差的患者群体）尚缺乏充分的疗效数据。本研究旨在描述未经筛选的SCLC人群中化疗联合免疫治疗的真实世界疗效。我们开展了一项回顾性多中心研究，比较了巴黎大区六家学术中心收治的两个初治转移性SCLC患者队列。队列1纳入2017年1月至2018年12月期间接受化疗的患者，队列2纳入2019年1月至2020年12月期间接受化疗联合免疫治疗的患者。研究共纳入153例连续患者（队列1：96例；队列2：57例）。两组患者的临床特征基本相似。队列2的总生存期（中位生存期15.47个月）在统计学上显著优于队列1（中位生存期9.5个月）（p=0.0001）。对于体能状态评分≥2分及年龄≥70岁的患者，两组间总生存期无统计学差异。在存在脑转移或肝转移的情况下，化疗联合免疫治疗的疗效显著优于单纯化疗。综上所述，化疗联合免疫治疗在转移性SCLC中显示出真实世界的总生存获益。未来需要开展专门针对体能状态较差或高龄患者的临床试验以验证该策略的疗效。
肿瘤(癌症)患者之家