# A Retrospective Real-World Study: The Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Chemoradiotherapy in Limited-Stage Small Cell Lung Cancer

## TL;DR

This study finds that adding immunotherapy to standard treatment for limited-stage small cell lung cancer improves survival, especially for patients with type 2 diabetes.

## Contribution

Shows that immunotherapy combined with chemoradiotherapy improves progression-free survival in limited-stage small cell lung cancer.

## Key findings

- Immunotherapy combined with chemoradiotherapy led to significantly longer progression-free survival (11.89 vs. 8.94 months).
- Type 2 diabetes was associated with survival prognosis and patients with it may benefit more from immunotherapy combinations.
- Patients in TNM stage IIIB had worse outcomes compared to earlier stages.

## Abstract

To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer (LS-SCLC). We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.

We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) (Group A) and immunotherapy combined with CCRT/SCRT followed by immunotherapy (Group B), to assess the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Factors affecting prognosis were also explored using Cox analysis. The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.

The overall ORR was 55.93%. The overall DCR was 98.31%. The DCR was 100% in Group A and 96.61% in Group B. There was no statistical difference in ORR and DCR. The overall median PFS was 9.86 months (95% CI, 8.62–11.10), and the difference in median PFS between the two groups was statistically significant (8.94 vs. 11.89 months, p = 0.03). The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis. Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT. Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I + II + IIIA.

We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT. Type 2 diabetes and TNM stage affect the survival prognosis. Patients with type 2 diabetes may benefit from immunotherapy combination treatments.