Combined Immunotherapy & Chemotherapy Improves Survival in Extensive-Stage SCLC

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Real-world data show first-line chemo-immunotherapy improves survival and response rates over chemo alone in extensive-stage SCLC, supporting its broader use.

A recent retrospective study evaluated whether combining chemotherapy with immunotherapy offers superior outcomes compared to chemotherapy alone in the first-line treatment of extensive-stage small cell lung cancer (ES-SCLC). The findings were presented at ASCO 2025.

Conducted at the Fourth Hospital of Hebei Medical University, the study aimed to provide real-world evidence that could help inform and guide clinical decision-making.

The researchers analyzed data from 574 patients diagnosed with ES-SCLC. Researchers collected detailed information on clinicopathological characteristics, baseline peripheral blood biomarkers, treatment types, and survival outcomes.

To reduce bias and ensure comparability between groups, propensity score matching was used to balance baseline characteristics between the chemotherapy-only group and the group receiving combined chemotherapy and immunotherapy. The study team employed Kaplan-Meier analysis to estimate progression-free survival (PFS) and overall survival (OS), and univariate Cox regression analysis was used to assess the impact of baseline characteristics on patient outcomes.

By the final follow-up on October 15, 2024, a total of 434 deaths (75.6%) had been recorded. The results demonstrated that patients who received the combination therapy experienced better outcomes. The objective response rate (ORR) was 75.6% in the combination group, compared to 60.4% in the chemotherapy-only group. The combination group also showed improved survival rates, with 1-, 2-, and 3-year OS rates of 35%, 23%, and 23%, respectively, versus 23%, 14%, and 12% in the chemotherapy-only group. The median PFS was 8 months in the combination group, compared to 6 months in the chemotherapy group. Median OS also favored the combination therapy, with 15 months versus 13 months in the chemotherapy-only group.

Univariate analysis across multiple baseline characteristics—including age, gender, smoking status, ECOG performance status, and presence of brain, bone, or liver metastases—consistently showed a reduced risk of progression and death in the combination group.

“This retrospective study further confirmed that in real-world first-line treatment of ES-SCLC, chemotherapy combined with immunotherapy provides superior efficacy and prognosis compared to chemotherapy alone,” the study authors noted.