Efficacy analysis of second-line chemotherapy combined with immunotherapy in extensive-stage small cell lung cancer
Objective To explore the efficacy of second-line chemotherapy combined with immunotherapy after the progression of first-line standard chemotherapy combined with immunotherapy in extensive-stage small cell lung cancer(ES-SCLC).Methods A retrospective analysis was conducted on 46 patients diagnosed with ES-SCLC at Fujian Cancer Hospital from January 2019 to December 2022.Among them,there were 43 males and 3 females,with a mean age of(61.33±7.87)years.27 cases in the second-line chemotherapy combined with immunotherapy group(immunotherapy cross-line group)after progression of first-line treatment,and 19 cases in the second-line chemotherapy without immunotherapy group(immunotherapy non-cross-line group)after progression of first-line treatment were analyzed for differences in clinical pathological characteristics,short-term treatment efficacy,and survival.Results There were no statistically significant differences in gender,age,tumor metastasis sites,and use of immunotherapy between the immunotherapy cross-line group and the immunotherapy non-cross-line group(all P＞0.05).In the immunotherapy cross-line group,after first-line treatment,23 patients achieved partial response(PR)and 4 patients had stable disease(SD);after second-line treatment,2 patients had PR,13 had SD,and 12 had progressive disease(PD).In the immunotherapy non-cross-line group,after first-line treatment,14 patients had PR,3 had SD,and 2 had PD;after second-line treatment,1 patient had PR,7 had SD,and 11 had PD.The objective response rate(ORR)after second-line treatment was 7.4％(2/27)in the immunotherapy cross-line group and 5.3％(1/19)immunotherapy non-cross-line group,with disease control rates(DCR)of 55.6％(15/27)and 42.1％(8/19),respectively.There were no statistically significant differences in ORR and DCR between the two groups(P=0.772 and P=0.549,respectively).The median progression-free survival(PFS)after second-line treatment was longer in the immunotherapy cross-line group than in the immunotherapy non-cross-line group(88 days vs.67 days),but the difference was not statistically significant(P=0.454).The total survival time after second-line treatment showed a trend of extension in the immunotherapy cross-line group compared to the immunotherapy non-cross-line group(382 days vs.335 days,P=0.104).Conclusion Second-line chemotherapy combined with immunotherapy after the progression of first-line immunotherapy in ES-SCLC has a certain trend of prolonging patient PFS and OS compared to chemotherapy alone.
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