{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:01:25Z","timestamp":1790226085554,"version":"4.1.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small-cell lung cancer (SCLC) is a highly aggressive neuroendocrine malignancy. Immune checkpoint inhibitors (ICIs) combined with chemotherapy have become a standard first-line treatment for extensive-stage SCLC; however, their effectiveness across different clinical settings in real-world practice remains incompletely characterized. This study aimed to retrospectively evaluate the clinical effectiveness of ICI-based therapy across subgroups defined by disease stage, surgery, and radiotherapy status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with histologically or cytologically confirmed SCLC treated at Tianjin Medical University General Hospital between January 2010 and December 2024 were retrospectively included and classified into ICI and non-ICI groups according to treatment exposure. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was the 12-month objective response rate (ORR). Survival outcomes were estimated using the Kaplan\u2013Meier method and compared using the log-rank test. Multivariable Cox proportional hazards regression was performed to adjust for clinically relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 142 patients were included, including 76 in the ICI group and 66 in the non-ICI group. ICI therapy was associated with significantly longer OS in patients with limited-stage SCLC (52 vs. 24 months; HR\u00a0=\u00a00.31, P\u00a0=\u00a00.011), extensive-stage SCLC (28 vs. 12 months; HR\u00a0=\u00a00.29, P\u00a0=\u00a00.007), stage IIIB\u2013C disease (46 vs. 21 months; HR\u00a0=\u00a00.37, P\u00a0=\u00a00.038), and stage IV disease (30 vs. 11 months; HR\u00a0=\u00a00.26, P\u00a0=\u00a00.007). Significant PFS improvements were observed primarily in patients with stage IV disease (9 vs. 5 months; HR\u00a0=\u00a00.31, P\u00a0=\u00a00.002) and extensive-stage disease (10 vs. 5 months; HR\u00a0=\u00a00.36, P\u00a0=\u00a00.003). A significantly higher ORR was observed in the ES-SCLC subgroup, while a numerical increase was observed in the stage IV subgroup. Subgroup analyses further suggested more pronounced survival improvements associated with ICI therapy among patients who did not undergo surgery or radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICI-based therapy was associated with improved survival outcomes in patients with SCLC, with the most consistent benefits observed in advanced-stage disease. More apparent treatment-associated benefits were also observed among patients who did not undergo surgery or radiotherapy. These findings provide real-world evidence supporting the use of ICI-based therapy in SCLC, particularly in advanced-stage disease, but should be interpreted cautiously given the retrospective design and subgroup sample sizes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1940634","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:32:58Z","timestamp":1790224378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Greater survival benefits in small cell lung cancer patients: a real-world study with immune checkpoint inhibitors therapy"],"prefix":"10.3389","volume":"16","author":[{"given":"Penghu","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanguang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwen","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Lung Cancer Surgery, Center of Thoracic Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]},{"name":"Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical 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Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer","volume":"348","author":"Rizvi","year":"2015","journal-title":"Science"},{"key":"B16","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/nature14664","article-title":"Comprehensive genomic profiles of small cell lung cancer","volume":"524","author":"George","year":"2015","journal-title":"Nature"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1940634\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:33:12Z","timestamp":1790224392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1940634\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":16,"alternative-id":["10.3389\/fonc.2026.1940634"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1940634","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"article-number":"1940634"}}