{"doi":"10.1002/cam4.70256","title":"The Optimal First‐Line Therapy for Extensive‐Stage Small‐Cell Lung Cancer Based on Liver Metastasis Status: A Network Meta‐Analysis and Systematic Review","abstract":"<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>To compare the efficacy of first‐line regimens based on programmed cell death (or ligand) [PD‐(L)1] blockade in extensive‐stage small‐cell lung cancer (ES‐SCLC) patients with or without liver metastases (LM), and to identify optimal treatment strategies.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Network meta‐analysis of randomized controlled trials (RCTs) comparing chemo‐immunotherapy (CIT) and chemotherapy (CT) in ES‐SCLC patients stratified by LM. Overall survival (OS) and progression‐free survival (PFS) were evaluated using hazard ratios (HRs) and 95% confidence intervals (CIs).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Seven RCTs involving 3658 ES‐SCLC patients (1243 with LM, 2415 without LM) were analyzed. For patients with LM, the combination therapies of anti‐PD‐1 + CT (HR, 0.67; 95% CI, 0.54%–0.82%; <jats:italic>p</jats:italic> &lt; 0.001) and anti‐PD‐L1 + CT + anti‐angiogenesis (HR, 0.84; 95% CI, 0.71%–0.99%; <jats:italic>p</jats:italic> = 0.042) demonstrated superior efficacy in prolonging OS compared to CT alone. The anti‐PD‐1 + CT regimen had the highest cumulative probability of 91.6% for extending OS in patients with LM. For patients without LM, all CIT regimens resulted in improved OS compared to CT alone, with the regimen of anti‐angiogenesis + anti‐PD‐L1 + CT ranking first and having the highest cumulative probability of 95.5% for prolonging OS.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>CIT is effective for ES‐SCLC patients regardless of LM status. For patients with LM, PD‐1 blockade combined with CT is the best option. For patients without LM, the most beneficial regimen is the combination of anti‐angiogenesis, PD‐L1 blockade, and CT.</jats:p></jats:sec>","journal":"Cancer Medicine","year":2024,"id":608549,"datarank":0.29188652235829704,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.0,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":969419,"name":"Jing Yu","orcid":"0000-0003-2485-2286","position":1,"is_corresponding":false},{"id":822334,"name":"Yuan Tian","orcid":"0000-0001-8158-1588","position":2,"is_corresponding":false},{"id":1563081,"name":"Jie‐Hui Zhang","orcid":null,"position":3,"is_corresponding":false},{"id":310604,"name":"Li Sun","orcid":"0000-0001-8228-7487","position":4,"is_corresponding":false},{"id":1563082,"name":"Le‐Tian Huang","orcid":"0000-0002-1889-743X","position":5,"is_corresponding":false},{"id":1563083,"name":"Jie‐Tao Ma","orcid":null,"position":6,"is_corresponding":false},{"id":1563084,"name":"Cheng‐Bo Han","orcid":"0000-0001-8391-6134","position":7,"is_corresponding":false},{"id":1563080,"name":"Shu‐Ling Zhang","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The Optimal First‐Line Therapy for Extensive‐Stage Small‐Cell Lung Cancer Based on Liver Metastasis Status: A Network Meta‐Analysis and Systematic Review","abstract":"<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>To compare the efficacy of first‐line regimens based on programmed cell death (or ligand) [PD‐(L)1] blockade in extensive‐stage small‐cell lung cancer (ES‐SCLC) patients with or without liver metastases (LM), and to identify optimal treatment strategies.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Network meta‐analysis of randomized controlled trials (RCTs) comparing chemo‐immunotherapy (CIT) and chemotherapy (CT) in ES‐SCLC patients stratified by LM. Overall survival (OS) and progression‐free survival (PFS) were evaluated using hazard ratios (HRs) and 95% confidence intervals (CIs).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Seven RCTs involving 3658 ES‐SCLC patients (1243 with LM, 2415 without LM) were analyzed. For patients with LM, the combination therapies of anti‐PD‐1 + CT (HR, 0.67; 95% CI, 0.54%–0.82%; <jats:italic>p</jats:italic> &lt; 0.001) and anti‐PD‐L1 + CT + anti‐angiogenesis (HR, 0.84; 95% CI, 0.71%–0.99%; <jats:italic>p</jats:italic> = 0.042) demonstrated superior efficacy in prolonging OS compared to CT alone. The anti‐PD‐1 + CT regimen had the highest cumulative probability of 91.6% for extending OS in patients with LM. For patients without LM, all CIT regimens resulted in improved OS compared to CT alone, with the regimen of anti‐angiogenesis + anti‐PD‐L1 + CT ranking first and having the highest cumulative probability of 95.5% for prolonging OS.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>CIT is effective for ES‐SCLC patients regardless of LM status. For patients with LM, PD‐1 blockade combined with CT is the best option. For patients without LM, the most beneficial regimen is the combination of anti‐angiogenesis, PD‐L1 blockade, and CT.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39358989","pmcid":"PMC11447196","openalex_id":"https://openalex.org/W4403082701","authors":[],"funders":[{"funder_name":"National Natural Science Foundation of China","grant_id":"82103338","title":null},{"funder_name":"345 Talent Project of Shengjing Hospital","grant_id":"","title":null},{"funder_name":"345 Talent Project of Shengjing Hospital","grant_id":"","title":null}],"total_grants":3,"fwci":0.8115,"citation_percentile":0.64990099,"influential_citations":0,"citation_trend":[{"year":2025,"count":4},{"year":2026,"count":2}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.70256","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/cam4.70256","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1002/cam4.70256","host_type":"publisher"},{"url":"https://doi.org/10.1002/cam4.70256","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39358989","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11447196","host_type":"repository"},{"url":"https://doaj.org/article/4f4d3c62a1a74e999b28525cf4eb0040","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11447196/pdf/CAM4-13-e70256.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11447196","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11447196?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Lung Cancer Research Studies","Hepatocellular Carcinoma Treatment and Prognosis","Cancer Immunotherapy and Biomarkers","Humans","Antineoplastic Combined Chemotherapy Protocols","Immune Checkpoint Inhibitors","Liver Neoplasms","Lung Neoplasms","Neoplasm Staging","Progression-Free Survival","Randomized Controlled Trials as Topic","Small Cell Lung Carcinoma"],"mesh_terms":["Network Meta-Analysis","Progression-Free Survival","Immune Checkpoint Inhibitors","Antineoplastic Combined Chemotherapy Protocols","Humans","Liver Neoplasms","Lung Neoplasms","Neoplasm Staging","Randomized Controlled Trials as Topic","Small Cell Lung Carcinoma"],"keywords":["Medicine","Regimen","Hazard ratio","Internal medicine","Lung cancer","Oncology","Confidence interval","Randomized controlled trial","Meta-analysis","Gastroenterology","Immunotherapy","Liver Metastases","Meta‐analysis","Small‐cell Lung Cancer"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-30T18:26:04.201891Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}