Clinical efficacy and safety of immune checkpoint inhibitors plus anlotinib as secondline or subsequent therapy in extensive stage small cell lung cancer: a retrospective study

• Yanan Wu ^[1] ; Yan Zhang ^[1] ; Yuanjing Tian ^[1] ; Yajuan Lv ^[1] ; Jiandong Zhang ^[1]
  1. [1] Department of Oncology, The First Afliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, Jinan, China
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 27, Nº. 3, 2025, págs. 1026-1038
• Idioma: inglés
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• Resumen

  • Background Treatments are limited for extensive stage small cell lung cancer (ES-SCLC) patients in secondline or subsequent setting. This study aimed to explore the clinical efcacy and safety of immune checkpoint inhibitors (ICIs) plus anlotinib as secondline or subsequent therapy in ES-SCLC.

    Methods We retrospectively analyzed 116 patients with ES-SCLC at Shandong Provincial Qianfoshan Hospital between January 2019 and March 2024. According to anlotinib as secondline or subsequent therapy group (ICI+anlotinib group), single ICI as secondline or subsequent therapy group (single ICI therapy group), single chemotherapy as secondline therapy group (single chemotherapy group). Kaplan–Meier method was used to compare the progression-free survival (PFS) and the overall survival time (OS) among these three groups. Cox regression analysis was used to analyze diferent factors which correlated to PFS and OS. The adverse events were assessed according to the Common Terminology Criteria for Adverse Events version 5.0.

    Results Kaplan–Meier analysis showed that patients in ICI+anlotinib group had a longer PFS and OS compared to patients in single ICI therapy group (median PFS [mPFS]: 6.7 months vs. 4.6 months, P=0.007; median OS [mOS]:12.4 months vs. 8.4 months, P=0.041) and single chemotherapy group (mPFS: 6.7 months vs. 3.0 months, P<0.001; mOS: 12.4 months vs. 7.2 months, P=0.002). The Cox regression analysis showed that the Eastern Cooperative Oncology Group performance status (ECOG PS), liver metastasis, brain metastasis and treatment regimes were independent predictors that afecting the PFS and OS of all the enrolled patients. The common adverse events (AEs) were wleukopenia and fatigue. There was no signifcant statistical diference in other AEs among the three groups except for leukopenia.

    Conclusion ICI+anlotinib as secondline or subsequent therapy has better efcacy than single ICI group and single chemotherapy group and with tolerable toxicities for patients with ES-SCLC.