Efficacy and Safety of First-Line Chemotherapy-Based Combination Therapy for Patients With Extensive-Stage Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis.

Background: Multiple first-line chemotherapy-based combination regimens are available for patients with extensive-stage small cell lung cancer (ES-SCLC), however, direct head-to-head comparisons remain limited. This network meta-analysis (NMA) aimed to indirectly compare the efficacy and safety of v...

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Publicado en:Clinical Medicine Insights: Oncology Vol. 19; pp. 1 - 12
Autores principales: Zhao, Qingfang, Liu, Xiaomin, Yu, Minghua, Chen, Jinglong
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. 8/28/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 8/28/2025
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        atl: Efficacy and Safety of First-Line Chemotherapy-Based Combination Therapy for Patients With Extensive-Stage Small Cell Lung Cancer: A Systematic Review and Network Meta-Analysis.
      aug:
        au:
          Zhao, Qingfang
          Liu, Xiaomin
          Yu, Minghua
          Chen, Jinglong
        affil: Cancer Center, Beijing Ditan Hospital, Capital Medical University, Beijing, China
      sug:
        subj:
          Carcinoma, Non-Small-Cell Lung Diagnosis
          Carcinoma, Non-Small-Cell Lung Drug Therapy
          Carcinoma, Non-Small-Cell Lung Mortality
          Antineoplastic Agents, Combined Therapeutic Use
          Antineoplastic Agents, Combined Adverse Effects
          Immunotherapy Methods
          Immunotherapy Adverse Effects
          Angiogenesis Inhibitors Therapeutic Use
          Angiogenesis Inhibitors Adverse Effects
          Drug Efficacy
          Patient Safety
          Treatment Outcomes
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Embase
          Cochrane Library
          Checklists
          Statistics
          Data Analysis Software
          Adverse Drug Event
          Quality of Life
          Brain Neoplasms Complications
          Liver Neoplasms Complications
          Immune Checkpoint Inhibitors Therapeutic Use
          Immune Checkpoint Inhibitors Adverse Effects
      ab: Background: Multiple first-line chemotherapy-based combination regimens are available for patients with extensive-stage small cell lung cancer (ES-SCLC), however, direct head-to-head comparisons remain limited. This network meta-analysis (NMA) aimed to indirectly compare the efficacy and safety of various first-line combination therapies. Methods: A comprehensive literature search was conducted across electronic databases and academic conference proceedings to identify eligible randomized controlled trials (RCTs). Bayesian network meta-analysis and systematic review were performed on the selected studies. Primary outcomes included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), along with adverse events of grade ⩾ 3 (grade ⩾ 3 AEs) and subgroup analyses. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022360249). Results: The analysis included 12 randomized trials encompassing 5840 patients and 14 treatment regimens. The combination of benmelstobart, anlotinib and chemotherapy showed the most significant improvement in PFS (hazard ratio [HR] = 0.33, 95% confidence interval [CI] = 0.26-0.41) and OS (HR = 0.61, 95% CI = 0.47-0.79) compared with chemotherapy alone. This regimen ranked highest for PFS (Bayesian ranking probability 99%) and OS (39%). However, it was also associated with a higher risk of Grade ⩾ 3 AEs (HR = 2.01, 95% CI = 1.09-3.73). In patients with baseline liver metastases, this regimen provided the greatest PFS benefit (99%), whereas serplulimab plus chemotherapy offered the best OS (53%). Conversely, for patients with baseline brain metastases, combination therapy failed to demonstrate a significant survival benefit. Conclusions: For treatment-naïve ES-SCLC patients, benmelstobart plus anlotinib plus chemotherapy yielded the most favorable outcomes in terms of PFS, OS and ORR, but a less favorable safety profile. These findings support its use as a potent therapeutic option in few patient populations.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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