First-line systemic treatment for people with extensive-stage small cell lung cancer: a network meta-analysis

作者：Ichimura T, Sugita H, Noma H, Yamaji N, Sunaga T, Sato MT, Maeda M, Toyoda S, Ota E, Hasegawa T · 发表于：The Cochrane database of systematic reviews · 年份：2026 · DOI：10.1002/14651858.cd015738.pub2 · 研究领域：Small Cell Lung Carcinoma、Lung Neoplasms、Antineoplastic Combined Chemotherapy Protocols、Immune Checkpoint Inhibitors、Humans、Randomized Controlled Trials as Topic、Etoposide、Cisplatin、Immunotherapy、Quality of Life、Antineoplastic Agents、Carboplatin

RATIONALE: Extensive-stage small cell lung cancer (SCLC) carries a poor prognosis and has limited therapeutic options. The addition of immune-checkpoint inhibitors (ICIs) to platinum-etoposide (PE) chemotherapy has become an important first-line treatment strategy. However, the comparative benefits and harms of different first-line chemotherapy-based regimens, including ICI-containing combinations, remain unclear. OBJECTIVES: To evaluate the comparative benefits and harms of immunotherapy (anti-PD-1, anti-PD-L1, or anti-CTLA-4), plus chemotherapy and other relevant first-line systemic chemotherapy-based regimens, for the first-line systemic treatment of extensive-stage SCLC with a network meta-analysis; to rank the interventions according to their benefits and harms; and to explore the potential role of biomarkers or clinical factors, where data are available. SEARCH METHODS: We used CENTRAL, MEDLINE, and Embase, together with clinical trial registries, to identify studies that were included in the review. The latest search date was 12 December 2025. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) comparing first-line systemic chemotherapy-based regimens, including chemotherapy alone, chemotherapy combined with ICIs, and other relevant combination strategies, in adults (≥ 18 years) with previously untreated extensive-stage SCLC. OUTCOMES: Critical outcomes were overall survival (OS) and adverse events (AEs). These include any grade AEs, serious AEs, ...