{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:52:35Z","timestamp":1781581955765,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Therapeutic progress for extensive\u2010stage small\u2010cell lung cancer (ES\u2010SCLC) has been limited. Although immune checkpoint inhibitors (ICIs) have been introduced, their real\u2010world impact on survival remains uncertain. We evaluated 25\u2010year survival trends and the association between ICI exposure and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive ES\u2010SCLC patients treated at a Japanese cancer center between April 1999 and March 2023 were retrospectively reviewed and grouped by diagnosis period: A (1999\u20132003), B (2004\u20132008), C (2009\u20132013), D (2014\u20132018), and E (2019\u20132023). OS from diagnosis to death was measured. Kaplan\u2013Meier\/log\u2010rank tests and multivariable Cox models were used. Subgroup analyses included patients aged \u2265\u200975\u2009years, with PS\u2009\u2265\u20092, and with brain metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 452 patients were included. Median OS in period A was 9.8\u2009months and in periods B\u2013E, it was 12.5, 13.4, 11.8, and 13.6\u2009months; 2\u2010year OS rates were 6.2%, 18.2%, 18.6%, 17.3%, and 28.9%, respectively. In multivariable analysis, PS\u2009\u2265\u20092 (HR 1.51), receipt of first\u2010line therapy (HR 0.09), and ICI exposure (HR 0.73;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) were independently associated with OS. ICI exposure was associated with longer OS (15.2 vs. 12.3\u2009months; 2\u2010year OS 32.1% vs. 15.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.005) among systemically treated patients. In subgroup analyses, ICI\u2010associated HRs were 0.67 in patients aged \u2265\u200975\u2009years, 0.69 in PS\u2009\u2265\u20092, and 0.63 in brain metastases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Real\u2010world survival in ES\u2010SCLC improved over 25\u2009years. ICI exposure was independently associated with improved OS, as well as in clinically high\u2010risk subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70316","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:27:28Z","timestamp":1780396048000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Survival Over 25\u2009Years in Extensive\u2010Stage Small\u2010Cell Lung Cancer: The Impact of Immune Checkpoint Inhibitors"],"prefix":"10.1111","volume":"17","author":[{"given":"Ryo","family":"Ariyasu","sequence":"first","affiliation":[{"name":"Department of Thoracic Medical Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teruhisa","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medical Oncology 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