WCLC 2025 - Posters & ePosters-EP.13.37 Immunotherapy Plus Chemoradiotherapy for Limited-Stage Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Trials

EP.13.37 Immunotherapy Plus Chemoradiotherapy for Limited-Stage Small Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Trials

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This systematic review and meta-analysis evaluated the impact of adding immune checkpoint inhibitors (ICIs) to chemoradiotherapy in patients with limited-stage small cell lung cancer (SCLC). Previous randomized trials of ICIs combined with chemoradiotherapy showed inconsistent results, prompting this study to assess overall survival (OS) outcomes and whether treatment factors modify ICI effectiveness.<br /><br />Five randomized trials involving 1461 patients were included, with varying treatment protocols: some used consolidation ICIs (durvalumab, nivolumab/ipilimumab, toripalimab, atezolizumab), one trial administered concurrent and consolidation atezolizumab. Chemotherapy regimens varied, with some using carboplatin-based combinations. Thoracic radiation dose schedules, use of prophylactic cranial irradiation (PCI), and ICI agents differed among studies.<br /><br />Meta-analysis findings indicated that adding ICIs to chemoradiotherapy modestly improved OS overall. Subgroup analyses suggested that the greatest survival benefit occurred when ICIs were combined with carboplatin-based chemotherapy regimens rather than cisplatin-based. Additionally, non-atezolizumab ICIs (such as durvalumab, nivolumab/ipilimumab, or toripalimab) appeared to confer greater benefit compared to atezolizumab. Timing of immunotherapy (concurrent vs. consolidation), thoracic radiation dose schedule, and PCI use did not significantly modify OS outcomes.<br /><br />In conclusion, for limited-stage SCLC patients undergoing definitive chemoradiotherapy, integrating ICIs is promising, particularly when carboplatin-based chemotherapy and non-atezolizumab agents are employed. These results generate hypotheses to optimize treatment combinations and guide future research on immunotherapy in this setting.<br /><br />Correspondence: chiaching.lee07@gmail.com

Asset Subtitle

Chia Ching Lee

Meta Tag

Speaker Chia Ching Lee

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

immune checkpoint inhibitors

chemoradiotherapy

limited-stage small cell lung cancer

overall survival

carboplatin-based chemotherapy

non-atezolizumab agents

durvalumab

nivolumab/ipilimumab

toripalimab

prophylactic cranial irradiation