ArticleThoracic cancer2026
Real-World Survival Over 25 Years in Extensive-Stage Small-Cell Lung Cancer: The Impact of Immune Checkpoint Inhibitors.
Article in Thoracic cancer, 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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12 authors.
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Abstract
introductionTherapeutic progress for extensive-stage small-cell lung cancer (ES-SCLC) has been limited. Although immune checkpoint inhibitors (ICIs) have been introduced, their real-world impact on survival remains uncertain. We evaluated 25-year survival trends and the association between ICI exposure and overall survival (OS).
methodsConsecutive ES-SCLC patients treated at a Japanese cancer center between April 1999 and March 2023 were retrospectively reviewed and grouped by diagnosis period: A (1999-2003), B (2004-2008), C (2009-2013), D (2014-2018), and E (2019-2023). OS from diagnosis to death was measured. Kaplan-Meier/log-rank tests and multivariable Cox models were used. Subgroup analyses included patients aged ≥ 75 years, with PS ≥ 2, and with brain metastases.
resultsA total of 452 patients were included. Median OS in period A was 9.8 months and in periods B-E, it was 12.5, 13.4, 11.8, and 13.6 months; 2-year OS rates were 6.2%, 18.2%, 18.6%, 17.3%, and 28.9%, respectively. In multivariable analysis, PS ≥ 2 (HR 1.51), receipt of first-line therapy (HR 0.09), and ICI exposure (HR 0.73; p = 0.013) were independently associated with OS. ICI exposure was associated with longer OS (15.2 vs. 12.3 months; 2-year OS 32.1% vs. 15.9%; p < 0.005) among systemically treated patients. In subgroup analyses, ICI-associated HRs were 0.67 in patients aged ≥ 75 years, 0.69 in PS ≥ 2, and 0.63 in brain metastases.
conclusionsReal-world survival in ES-SCLC improved over 25 years. ICI exposure was independently associated with improved OS, as well as in clinically high-risk subgroups.
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