Efficacy and Safety of PD-1/PD-L1 Inhibitor and Chemotherapy in Treatment of Advanced Small Cell Lung Cancer.

Context • SCLC has had few drugs for treatment and a high malignancy rate. About two-thirds of SCLC patients have distant metastasis by the time they receive a diagnosis, and once it occurs, patient’s survival time is short. Immunotherapy treatments can block immunosuppression and increase the body’s antitumor ability. PD-1 is the main immune checkpoint of tumors’ immune response, and PD-L1 is one of the ligands of PD-1. Objective • The study intended to analyze the therapeutic effects of inhibitors of programmed death-1 (PD-1)/ programmed cell death 1 ligand 1 (PD-L1) combined with chemotherapy for patients with advanced small cell lung cancer (SCLC), evaluate the safety of that treatment, and compare it with chemotherapy alone. Design • The research team performed a retrospective randomized controlled study. Setting •The study took place at Cangzhou Central Hospital. Participants • Participants were 72 patients with advanced SCLC who received treatment at the hospital between December 2021 and December 2022. Intervention • The research team divided participants into two groups, each with 36 participants, using the random number method: (1) the control group, which received platinum-etoposide chemotherapy, and (2) the intervention group, which received a PD-1/PD-L1 inhibitor combined with the same chemotherapy that the control group received. Outcome Measures • The research team examined: (1) short-term efficacy; (2) long-term efficacy; (3) tumor-marker levels—neuron-specific enolase (NSE), progastrin releasing peptide (ProGRP), cytokeratin-19-fragment (CYFRA21-1), and squamous cell carcinoma antigen (SCCA); (4) T lymphocyte-subset levels—cluster of differentiation 3+ (CD3+ ), CD4+, and CD8+ ; (5) adverse reactions, and (6) Karnofsky performance status (KPS) scores. Results • Compared with the control group, the intervention group’s: (1) overall response rate (ORR), with P = .002, and disease control rate (DCR), with P = .041, were significantly higher; (2) median survival time was significantly longer (P = .035); (3) levels of NSE, ProGRP, CYFRA21-1, and SCCA were significantly lower (all P < .001); (4) levels of CD3+ (P = .043) and CD4+ (P < .001) levels were significantly higher; and (5) Karnofsky performance status (KPS) scores were significantly higher than those of the control group (P = .018). No difference existed in the number of adverse reactions between the groups (P > .05). Conclusions • The PD-1/PD-L1 inhibitor combined with chemotherapy can benefit advanced SCLC patients, controlling patients’ conditions and improving their quality of life, with good safety. [ABSTRACT FROM AUTHOR]