ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicPredictive Biomarkers to Immune Checkpoint Inhibitors in Lung CancerView all 13 articles
Clinical impact of first-line chemotherapy combined with immune checkpoint inhibitors for limited-stage small cell lung cancer patients: a real-world propensity score matching study
Provisionally accepted
Quanman Hu1,2
Chenyi Zhou2Fei Zhao1Xiaoru Song1Yuan Ding1Xiyin Wang2Boying Wu2
Huina Wang1
Shuaiyin Chen1*Bin Jia2- 1Zhengzhou University, Zhengzhou, China
- 2The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Background: Findings from the ADRIATIC clinical trial revealed that adjuvant treatment with durvalumab following chemoradiotherapy (CRT) in limited-stage small cell lung cancer (LS-SCLC) significantly improved both overall survival (OS) and progression-free survival (PFS). However, the clinical impact remains uncertain in real-world clinical practice. Materials and Methods: We gathered data of LS-SCLC patients at the First Affiliated Hospital of Zhengzhou University and conducted propensity score-matched analysis (PSM), Kaplan-Meier (K-M) method and Cox proportional hazards regression. Results: Prior to PSM, survival results demonstrated the mOS of the chemotherapy group was 20.34 months (95% confidence interval (CI): 18.80 - 23.57 months), whereas that of the chemotherapy + ICIs group was 26.38 months (95% CI: 22.97 - 38.90 months); the hazard ratio (HR) was 0.603 (95% CI: 0.413 - 0.880, P = 0.008, sample siz: 102 vs 66). Simultaneously, the mPFS of the chemotherapy + ICIs group was also greater than that of the chemotherapy group, being 10.37 months (95% CI: 9.03 - 12.90 months) and 7.87 months (6.63 - 9.73 months), HR = 0.651 (95% CI: 0.457 - 0.927). After 1:1 matching for basic variables in the chemotherapy group (sample size: 66), its mOS was at 20.22 months, and mPFS was longer at 8.50 months. The multivariate analysis presented that radiotherapy, systemic immune-inflammation index (SII) > 666.29, and platelet-to-lymphocyte ratio (PLR) > 261.39 were independent prognostic factors for OS. Conclusion: These results offer reliable references for clinicians when formulating treatment strategies for LS-SCLC patients and also provide support for future clinical trials.
Keywords: chemotherapy, Cox proportional hazards, ICIS, LS-SCLC, prognostic, PSM
Received: 23 Oct 2025; Accepted: 02 Jan 2026.
Copyright: © 2026 Hu, Zhou, Zhao, Song, Ding, Wang, Wu, Wang, Chen and Jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuaiyin Chen
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