ArticleJournal of thoracic disease2026
Impact of liver metastasis on the efficacy of first-line chemoimmunotherapy in extensive-stage small-cell lung cancer: a retrospective cohort study.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The combination of immune checkpoint inhibitors and chemotherapy is the standard first-line treatment for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, predictive biomarkers for treatment efficacy are lacking. This study aimed to investigate the association between clinical characteristics, particularly liver metastasis, and survival outcomes in patients with ES-SCLC treated with chemoimmunotherapy. Methods: We conducted a retrospective analysis of 279 patients with ES-SCLC treated at the Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (102 receiving chemoimmunotherapy and 177 receiving chemotherapy alone). The association of clinical features with progression-free survival (PFS) and overall survival (OS) was assessed via Cox regression. Furthermore, a meta-analysis of five randomized controlled trials (IMpower133, CAPSTONE-1, CASPIAN, ETER701, and RATIONALE-312) was performed to confirm the effect of liver metastases on the efficacy of chemoimmunotherapy. Results: The cohort of 279 patients with ES-SCLC was predominantly male (92.1%), and the vast majority had a smoking history (85.7%). The median age was 61.4 years, and 18.6% of cases included involvement of more than three organs. The prevalence of brain, liver, and bone metastases was 22.2%, 25.1%, and 32.3%, respectively. Patients without liver metastases derived significantly greater survival benefit from chemoimmunotherapy than from chemotherapy alone (PFS: 8.9 Conclusions: The presence of liver metastases is a critical prognostic factor for outcomes in patients with ES-SCLC. These patients derive limited benefit from the current standard of care, underscoring the urgent need for novel therapeutic strategies to improve the prognosis of this subgroup.
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