ArticleTranslational oncology2023
Patterns of treatment failure for PD-(L)1 refractory extensive-stage small cell lung cancer in continued PD-(L)1 treatment.
Article in Translational oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Advancing immune checkpoint inhibitor rechallenge: key insights into efficacy, safety, and personalized strategies in advanced solid tumors.Frontiers in oncology · 2026Pooled it
- Real-world serplulimab plus chemotherapy for extensive-stage small cell lung cancer in china: an external validation of ASTRUM-005 trial.BMC medicine · 2026Observational
- Consolidation thoracic radiotherapy following quadruple induction with benmelstobart, anlotinib, and chemotherapy for extensive-stage small cell lung cancer: rationale and protocol of a phase II study.Translational lung cancer research · 2026Article
- Consolidative thoracic radiotherapy following first-line chemo-immunotherapy in extensive-stage small-cell lung cancer: A systematic review and meta-analysis.Therapeutic advances in medical oncology · 2026Article
- Association of salvage radiotherapy with survival outcomes in extracranial oligoprogression after first-line therapy for extensive-stage small-cell lung cancer: a multicenter retrospective cohort study.Therapeutic advances in medical oncology · 2026Article
- Early radiotherapy improved survival of patients with extensive-stage small cell lung cancer treated with first-line chemo-immunotherapy.BMC cancer · 2025Article
- Benefit of Consolidation Thoracic Radiotherapy in Extensive-Stage Small-Cell Lung Cancer Patients Treated with Immunotherapy: Data from Slovenian Cohort.International journal of molecular sciences · 2025Article
- Efficacy and safety of integrating consolidative thoracic radiotherapy with immunochemotherapy in extensive-stage small cell lung cancer: a real-world retrospective analysis.Journal of thoracic disease · 2025Article
- Immune checkpoint inhibitors continuation beyond progression as second-line treatment for extensive-stage small-cell lung cancer: a real-world, multicenter analysis.Frontiers in immunology · 2025Article
- Clinical outcomes and safety of continuous immunotherapy beyond progression in patients with extensive-stage small cell lung cancer: a retrospective real-world study.Frontiers in immunology · 2025Article
- The role of radiotherapy in extensive-stage small cell lung cancer: insights from treatment failure patterns in the era of immunotherapy.BMC cancer · 2024Article
- Mechanisms of immunotherapy resistance in small cell lung cancer.Cancer drug resistance (Alhambra, Calif.) · 2024Review
- Radiotherapy for extensive-stage small-cell lung cancer in the immunotherapy era.Frontiers in immunology · 2023Review
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Authors and funding
11 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough immunotherapy greatly extends overall survival (OS) of patients with extensive-stage small cell lung cancer (ES-SCLC), a number of patients develop immunotherapy resistance (IR). Patterns of failure in ES-SCLC are not clarified. Our study aims to explore the clinical pattern of IR and prognostic factors for these patients.
methodsThe study was conducted from 117 ES-SCLC patients with immunotherapy between 2018 and 2022. Chi-square tests and Fishers' exact tests was used to explore failure patterns in different populations. Survival analyses of different progression patterns and subsequent treatment regimens were conducted by Kaplan-Meier curves and log-rank test.
results86 (73.5%) patients experienced IR. The patients with smoking (never smoker vs. current or ex-smoker, 59.5 % vs. 81.3%, P = 0.010), liver metastasis (extrahepatic metastasis vs. intrahepatic metastasis, 73.6 % vs. 90.9%, P = 0.050), and distant metastasis status (no distant metastasis vs. distant metastasis, 39.1 % vs. 81.9%, P<0.001) were associated with IR rates. Liver progression had a lower incidence in 1st line immunotherapy (1st line vs. ≥2nd lines, 14.0 % vs. 41.7%, P = 0.004) and a higher incidence in multiple progression (multiple progression vs. Oligo-progression, 39.4 % vs. 17.0%, P = 0.021). Cranial (41.7 % vs. 16.1%, P = 0.012) and distant lymph node (16.7 % vs. 3.2%, P = 0.049) progression were the main failure model for acquired IR in comparison to primary IR. Patients with new lesion progression only (17.73 vs. 9.17 months, P = 0.013) and non-hepatic progression (14.23 vs. 11.67 months, P = 0.042) had a longer OS. Patients in cross-line immunotherapy after IR had a favourable prognosis (17.07 vs. 11.93 months, P = 0.007).
conclusionThe most common failure pattern of immunotherapy for ES-SCLC was lung and regional lymph node progression. Brain and liver progression were the most common extra thoracic failure sites for 1st line and 2nd and more lines immunotherapy, respectively. There was a higher probability of primary IR in 2 lines and above immunotherapy. Patients with new only progression site and cross-line rechallenge immunotherapy had a better prognosis.
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