Real-world effectiveness and safety of adebrelimab as first-line treatment in patients with extensive-stage small cell lung cancer

Background: Extensive-stage small cell lung cancer (ES-SCLC) is a highly aggressive malignancy. Although immune checkpoint inhibitors (ICIs) combined with chemotherapy have become standard first-line therapy, real-world evidence is necessary to validate clinical trial findings. This study aimed to evaluate the real-world effectiveness and safety of adebrelimab-based therapy in Chinese patients with ES-SCLC. Methods: In this prospective, multicenter real-world study, patients with histologically or cytologically confirmed ES-SCLC received an adebrelimab-based regimen. The primary outcome was progression-free survival (PFS); secondary outcomes included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Cox regression analyses were performed to identify prognostic factors. Results: From February 2023 to July 2024, a total of 170 patients were enrolled. The median age was 69 years. None of the patients had received prior systemic therapy. The ORR was 69.4%, and the DCR was 89.4%. The median PFS (mPFS) was 7.03 months [95% confidence interval (CI): 6.08-8.05], and the median OS (mOS) was 14.29 months (95% CI: 11.89-17.12). Multivariate analysis showed that liver metastasis [hazard ratio (HR) =1.852, P=0.006], lactate dehydrogenase (LDH) greater than the upper limit of normal (ULN) (HR =1.704, P=0.046), hypertension (HR =1.578, P=0.03), and grade ≥3 adverse events (AEs) (HR =1.590, P=0.050) were independently associated with PFS. For OS, advanced age and liver metastasis (both P<0.05) remained significant prognostic factors. Treatment-related AEs occurred in 96.5% of patients, with grade ≥3 AEs in 19.4%. Conclusions: Adebrelimab-based therapy demonstrated promising real-world effectiveness and a manageable safety profile in patients with ES-SCLC.