Systematic review and network meta-analysis: evaluation of systemic therapies for platinum refractory or resistant small cell lung cancer
A partir d'une revue systématique de la littérature publiée jusqu'en juin 2025 (6 essais de phase III), cette méta-analyse évalue l'efficacité, du point de vue de la survie globale et de la survie sans progression, et la toxité des traitement systémiques (chimiothérapies, immunothérapies, thérapies ciblées) pour un cancer du poumon à petites cellules résistant ou réfractaire aux sels de platine
Background: Platinum-refractory/resistant (r/r) small cell lung cancer (SCLC) is associated with poor prognosis and limited treatment options. While chemotherapy has been the standard, recent randomized controlled trials (RCTs) have investigated immunotherapy and targeted therapies. In 2025, the DeLLphi-304 trial showed tarlatamab significantly improved overall survival (OS) and progression-free survival (PFS) versus standard chemotherapy (SC). However, no network meta-analysis (NMA) has compared systemic therapies in this setting.
Methods: We systematically searched major databases through June 2025 for phase III RCTs evaluating systemic therapies in platinum r/r SCLC. Extracted outcomes included OS, PFS, quality-of-life (QoL), overall response rate (ORR), and treatment-related adverse events (AEs). Indirect comparisons were performed using Markov Chain Monte Carlo methods, with treatment rankings assessed via SUCRA probabilities.
Results: Six phase III RCTs were identified. Tarlatamab and nivolumab improved OS over other treatments, with tarlatamab ranking highest (SUCRA 0.96) and demonstrating superior safety.
Conclusions: Tarlatamab provides the most favorable outcomes, supporting its consideration as a preferred therapy for platinum r/r SCLC.
Lung Cancer , résumé, 2025