The Favorable Short-Term Efficacy of Preexisting COPD for Extensive-Stage Small-Cell Lung Cancer Receiving Immunotherapy

作者：Chen Y, Liu H, Zhang J · 发表于：Cancer medicine · 年份：2026 · DOI：10.1002/cam4.72124 · 被引用次数：26 · 研究领域：Lung Neoplasms、Small Cell Lung Carcinoma、Pulmonary Disease, Chronic Obstructive、Antineoplastic Combined Chemotherapy Protocols、Immunotherapy、Immune Checkpoint Inhibitors、Humans、Female、Male、Aged、Etoposide、Carboplatin

BACKGROUND: Preexisting chronic obstructive pulmonary disease (COPD) is associated with favorable clinical efficacy in NSCLC patients undergoing immune checkpoint inhibitors (ICIs). But the impact of COPD comorbidities on SCLC patients that are receiving immunotherapy remains unclear. METHODS: Patients with extensive-stage SCLC (ES-SCLC) received carboplatin combined with etoposide (carboplatin-etoposide, EC group) or durvalumab plus carboplatin-etoposide (EC + PD-L1 group) treatment as first line therapy were collected. In EC + PD-L1 group, survival of patients with preexisting COPD and patients without preexisting COPD were further compared. RESULTS: A total of 120 ES-SCLC patients who met the eligibility criteria were included in this study. The median overall survival (OS) and the progression-free survival (PFS) were significantly longer in the EC + PD-L1 group than in the EC group, with a HR of 0.37 (95% CI, 0.16-0.88; p = 0.001) and 0.42 (95% CI, 0.23-0.77; p < 0.001), respectively. We further stratified groups by COPD status in EC + PD-L1 group and EC group. In EC + PD-L1 group, PFS was significantly prolonged in COPD group compared with the non-COPD group, with a HR of 0.57 (95% CI, 0.35-0.96; p = 0.018). The COPD group demonstrated a numerically higher objective response rate than the non-COPD group, though the difference was not statistically significant (p = 0.292). No OS benefit was found between the groups. CONCLUSION: Preexisting COPD status may be associated...