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Research Article: Real-world study of adebrelimab as first-line therapy for extensive-stage small cell lung cancer: a retrospective study

Date Published: 2025-10-13

Abstract:
Extensive-stage small cell lung cancer (ES-SCLC) has a poor prognosis, with historical median overall survival (OS) of 8–13 months under platinum-etoposide chemotherapy. While phase III trials established adebrelimab (anti-PD-L1) plus chemotherapy as a new standard, real-world evidence remains scarce. This study evaluated real-world efficacy, safety, and prognostic factors of first-line adebrelimab-based therapy. In this retrospective study, thirty-five patients with ES-SCLC receiving adebrelimab as first-line treatment were analyzed. Endpoints included objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), OS, and adverse events (AEs). Prognostic factors were assessed via Cox regression. Median age was 72 years; 88.6% were male, 85.7% had Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0–1, and 51.4% had ?2 metastatic sites. ORR was 62.8%, DCR 77.1%. Median PFS was 7.1 months (95% CI: 5.47–8.53), and median OS was 15.0 months (95% CI: 10.47–19.53). Multivariate analysis identified ECOG PS ?2 as an independent predictor of inferior PFS (HR = 9.446, p=0.013), while ?2 metastatic organs (HR = 3.594, p=0.046) and C-reactive Protein (CRP) ?5 mg/L (HR = 3.337, p=0.044) predicted worse OS. Grade 3–4 AEs occurred in 74.3% of patients, primarily hematologic toxicities (neutropenia: 51.4%); two cases (5.7%) of myocarditis were observed. Adebrelimab suggests potentially promising efficacy in ES-SCLC, aligning with pivotal trial data despite an older cohort. ECOG PS ?2, high metastatic burden, and elevated CRP independently predict poorer outcomes. Vigilant monitoring for hematologic toxicity and rare cardiotoxicity is warranted.

Introduction:
Extensive-stage small cell lung cancer (ES-SCLC) has a poor prognosis, with historical median overall survival (OS) of 8–13 months under platinum-etoposide chemotherapy. While phase III trials established adebrelimab (anti-PD-L1) plus chemotherapy as a new standard, real-world evidence remains scarce. This study evaluated real-world efficacy, safety, and prognostic factors of first-line adebrelimab-based therapy.

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