Background: Small cell lung cancer (SCLC) is a malignant carcinoma characterized by high proliferative rate and early metastatization with limited treatment options and poor prognosis. The approval of ICIs has established a new standard of care for extensive-stage (ES)-SCLC (5). Atezolizumab, an anti PD-L1 monoclonal antibody, has been the first immune checkpoint inhibitor (ICI) to be approved for SCLC patients. This study aims to retrospectively evaluate the real-world effectiveness and safety of atezolizumab in a cohort of patients with ES-SCLC.Methods: We conducted a monocentric retrospective analysis of SCLC patients who received atezolizumab in addition to chemotherapy, between January 2020 and December 2023. Study design endpoints included progression-free survival (PFS), overall survival (OS), and adverse events.Results: A total of 134 patients were included in this study. Out of 134 patients who began the CEA protocol, 100 continued maintenance. Currently, 25 are alive, 17 still on atezolizumab, 5 on second-line therapy, and 3 receiving best supportive care. The median age was 65 years. Patients received a median of four cycles of CEA (range 1–6 cycles), while the median number of atezolizumab maintenance cycles was eight (range 0–75). The overall median survival was 15 months, with patients who received more than 30 cycles of atezolizumab showing OS of 46.7% at 48 months. Common adverse events included skin disorders, pneumonitis, colitis, alanine, and aspartate deaminase increment, dysthyroidism, and blood disorders with only 3% of patients experiencing grade 3 or higher toxicities.Conclusions: In this real-world cohort, atezolizumab demonstrated comparable effectiveness to clinical trial results, with a manageable safety profile. These findings support the use of atezolizumab as a viable treatment option for ES-SCLC in routine clinical practice.
背景：小细胞肺癌（SCLC）是一种具有高增殖率和早期转移特征的恶性肿瘤，其治疗选择有限且预后不良。免疫检查点抑制剂（ICIs）的获批为广泛期（ES）-SCLC建立了新的治疗标准（5）。阿替利珠单抗作为一种抗PD-L1单克隆抗体，是首个获批用于SCLC患者的免疫检查点抑制剂。本研究旨在回顾性评估阿替利珠单抗在ES-SCLC患者队列中的真实世界疗效与安全性。 方法：我们对2020年1月至2023年12月期间接受化疗联合阿替利珠单抗治疗的SCLC患者进行了单中心回顾性分析。研究设计终点包括无进展生存期（PFS）、总生存期（OS）及不良事件。 结果：本研究共纳入134例患者。在开始CEA方案的134例患者中，有100例继续接受维持治疗。目前有25例患者存活，其中17例仍在接受阿替利珠单抗治疗，5例接受二线治疗，3例接受最佳支持治疗。患者中位年龄为65岁。患者接受CEA方案的中位周期数为4个周期（范围1-6周期），而阿替利珠单抗维持治疗的中位周期数为8个周期（范围0-75周期）。总体中位生存期为15个月，其中接受超过30个周期阿替利珠单抗治疗的患者在48个月时的OS率为46.7%。常见不良事件包括皮肤病变、肺炎、结肠炎、丙氨酸和天冬氨酸脱氢酶升高、甲状腺功能异常及血液系统疾病，仅3%的患者出现3级或以上毒性反应。 结论：在此真实世界队列中，阿替利珠单抗显示出与临床试验结果相当的疗效，且安全性可控。这些发现支持阿替利珠单抗作为常规临床实践中ES-SCLC可行治疗选择的应用。
肿瘤(癌症)患者之家