{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:18:49Z","timestamp":1781713129080,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82103338"],"award-info":[{"award-number":["82103338"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare the efficacy of first\u2010line regimens based on programmed cell death (or ligand) [PD\u2010(L)1] blockade in extensive\u2010stage small\u2010cell lung cancer (ES\u2010SCLC) patients with or without liver metastases (LM), and to identify optimal treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Network meta\u2010analysis of randomized controlled trials (RCTs) comparing chemo\u2010immunotherapy (CIT) and chemotherapy (CT) in ES\u2010SCLC patients stratified by LM. Overall survival (OS) and progression\u2010free survival (PFS) were evaluated using hazard ratios (HRs) and 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven RCTs involving 3658 ES\u2010SCLC patients (1243 with LM, 2415 without LM) were analyzed. For patients with LM, the combination therapies of anti\u2010PD\u20101\u2009+\u2009CT (HR, 0.67; 95% CI, 0.54%\u20130.82%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and anti\u2010PD\u2010L1\u2009+\u2009CT\u2009+\u2009anti\u2010angiogenesis (HR, 0.84; 95% CI, 0.71%\u20130.99%; <jats:italic>p<\/jats:italic>\u2009=\u20090.042) demonstrated superior efficacy in prolonging OS compared to CT alone. The anti\u2010PD\u20101\u2009+\u2009CT regimen had the highest cumulative probability of 91.6% for extending OS in patients with LM. For patients without LM, all CIT regimens resulted in improved OS compared to CT alone, with the regimen of anti\u2010angiogenesis\u2009+\u2009anti\u2010PD\u2010L1\u2009+\u2009CT ranking first and having the highest cumulative probability of 95.5% for prolonging OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CIT is effective for ES\u2010SCLC patients regardless of LM status. For patients with LM, PD\u20101 blockade combined with CT is the best option. For patients without LM, the most beneficial regimen is the combination of anti\u2010angiogenesis, PD\u2010L1 blockade, and CT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70256","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T06:01:08Z","timestamp":1727935268000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Optimal First\u2010Line Therapy for Extensive\u2010Stage Small\u2010Cell Lung Cancer Based on Liver Metastasis Status: A\u00a0Network Meta\u2010Analysis and Systematic Review"],"prefix":"10.1002","volume":"13","author":[{"given":"Shu\u2010Ling","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Oncology Shengjing Hospital of China Medical University  Shenyang China"},{"name":"Innovative Cancer Drug Research and Development Engineering Center of Liaoning Province  Shenyang China"},{"name":"Department of Immunology, School of Basic Medical 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