SynthesisBMC cancer2026
Efficacy and tolerability of first-line treatment regimens for extensive-stage small cell lung cancer - a grade-assessed network meta-analysis of randomized controlled trials.
Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe treatment landscape for extensive-stage small-cell lung cancer (ES-SCLC) has advanced with the introduction of immunotherapy, targeted therapy, and novel chemotherapy combinations. A comprehensive evaluation of safety and efficacy across these treatments remains essential. This study aimed to compare the outcomes of all first-line treatment regimens for ES-SCLC.
methodsA systematic literature search of PubMed, Scopus, and Web of Science databases was conducted from inception to June 2025 to identify randomized controlled trials evaluating first-line treatments for ES-SCLC (CRD42024543408). Etoposide plus platinum (EP), the standard regimen, was used as the reference treatment. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included objective response rate (ORR) and adverse events (AEs). Hazard ratios (HR) were used for survival outcomes, and risk ratios (RR) for efficacy outcomes. A frequentist network meta-analysis was performed using the Netmeta R package (v2.9-0). Risk of bias was assessed using the Cochrane risk of bias tool v2, and certainty of evidence was evaluated according to GRADE guidelines.
resultsThis analysis included 34 studies with 10,658 participants and 22 treatment regimes. For OS, immunotherapy-based regimens such as Serplulimab + EP (HR = 0.63, 95% CI: 0.44–0.90, p = 0.01), Atezolizumab + EP (HR = 0.70, 95% CI: 0.49–1.00, p = 0.05), and Durvalumab + EP (HR = 0.71, 95% CI: 0.53–0.96, p = 0.02) showed significant improvements compared to EP. For PFS, Serplulimab + EP provided the greatest benefit (HR = 0.48, 95% CI: 0.31–0.75, p = 0.0012). Irinotecan + platinum was the only regimen to significantly improve the complete response rate (CRR) (RR = 1.91, 95% CI: 1.06–3.46, p = 0.03). Safety outcomes varied: Atezolizumab + EP and Tiragolumab + Atezolizumab + EP demonstrated lower risks of treatment discontinuation, while regimens such as Ipilimumab + EP and Tislelizumab + EP were associated with increased risks of serious AEs. Heterogeneity was generally low, with moderate variability observed for PFS and AEs leading to discontinuation.
conclusionImmunotherapy-based combinations, particularly Serplulimab + EP, demonstrated improved survival outcomes while maintaining an acceptable safety profile in most cases. However, some regimens showed increased AE risks. Future research should prioritize long-term outcomes and focus on balancing efficacy and tolerability to optimize therapeutic strategies.
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