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Rethinking immunotherapy in patients with SCLC with poor performance status

Mené sur 57 patients atteints d'un cancer du poumon à petites cellules de stade étendu et présentant un faible statut de performance (âge médian : 73,5 ans), cet essai de phase II évalue l'efficacité, du point de vue du taux de survie à 1 an, et la toxicité d'un traitement de première ligne combinant durvalumab, carboplatine et étoposide

The addition of immune checkpoint inhibitors (ICI) to first-line platinum-doublet chemotherapy has substantially improved long-term outcomes in a subset of patients with extensive-stage small-cell lung cancer (SCLC), with 3-year survival rates reaching 16–18%, compared with approximately 6% with chemotherapy alone, as shown in phase 3 studies such as the CASPIAN and IMpower133 trials.1,2 However, these trials were highly selective, excluding patients with poor Eastern Cooperative Oncology Group performance status (ie, ≥2) and impaired organ function, raising concerns about the generalisability of their outcomes to real-world settings, in which 33–88% of patients would not have met eligibility criteria.

The Lancet Respiratory Medicine , commentaire, 2025

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