Immune checkpoint inhibitors (ICIs) are approved for treatment of small cell lung cancer (SCLC). However, according to Yulian Xu and colleagues, the efficacy and safety of ICIs in relapsed SCLC are unclear. They performed a systematic review of published ICI studies and reported that “the administration of ICIs resulted in a similar survival outcome and acceptable safety compared with chemotherapy” for patients with relapsed SCLC.
Their analysis, published in the Journal of Clinical Pharmacy and Therapeutics, included eight studies, comprised of 653 patients who received ICIs. The primary measures assessed in the review were survival, treatment response, and safety.
Immune Checkpoint Inhibitor Treatment Results
According to the authors, the overall response rate (ORR) of the ICI patients was 0.12 (95% confidence interval [CI], 0.07–0.18), The median overall survival was 7.97 months (95% CI, 5.94–9.47), while the median progression-free survival was 1.70 months (95% CI, 1.40–2.28).
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Notably, chemotherapy had a favorable ORR (odds ratio [OR] = 0.74; 95% CI, 0.39–1.41; p = 0.36) and a significantly better disease control rate (OR = 0.28; 95% CI, 0.11–0.70; p = 0.007), but “patients treated with ICIs had a reduced risk of mortality (hazard ratio = 0.87; 95% CI, 0.73–1.03; p = 0.10).” The rates of all adverse events (AEs) grade III or higher AEs were 0.56 (95% CI, 0.52–0.60) and 0.13 (95% CI, 0.06–0.20), respectively.
Xu and the study’s collaborators concluded that ICI therapy appeared to have outcomes comparable to chemotherapy and suggested that “further studies are needed to explore potential biomarkers for relapsed SCLC patients who may benefit from immunotherapy.”
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