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Real-world comparison of chemoimmunotherapy and chemotherapy alone in elderly patients (≥75 years) with extensive-stage small cell lung Cancer

Future Oncol. 2026 Jun 27:1-9. doi: 10.1080/14796694.2026.2687697. Online ahead of print.

ABSTRACT

INTRODUCTION: Given the underrepresentation of adults aged ≥75 years with extensive-stage small-cell lung cancer (ES-SCLC) in clinical trials, we compared first-line chemoimmunotherapy versus chemotherapy in this population.

METHODS: This retrospective study enrolled 88 patients aged ≥75 years with ES-SCLC treated with either chemotherapy alone (n = 42) or chemoimmunotherapy (n = 46). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS) and safety. Multivariable Cox regression and stabilized inverse probability of treatment weighting (IPTW) analyses were performed to reduce confounding.

RESULTS: Median OS and PFS were 14.3 (95% CI: 11.6-22.5) and 6.6 in the chemotherapy group and 16.9 (95% CI: 12.7-NA) and 7.6 months in the chemoimmunotherapy group, respectively (HR: 0.90, 95% CI: 0.51-1.58, p = 0.71; HR: 0.75, 95% CI: 0.43-1.29, p = 0.30, respectively). Multivariate analysis identified smoking status as an independent predictor of OS (HR: 2.10, 95% CI: 1.01-4.38, p = 0.048).

CONCLUSION: Among patients aged ≥75 years with ES-SCLC, chemoimmunotherapy was associated with numerically longer OS compared with chemotherapy alone, although this difference did not reach statistical significance.

PMID:42363803 | DOI:10.1080/14796694.2026.2687697

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