Article
作者: Wang, Minghui ; Wang, Qiming ; Xie, Conghua ; Chen, Xingwu ; Zhuang, Wu ; Huang, Chun ; Wang, Jie ; Lin, Haifeng ; Jiang, Ou ; Shu, Yongqian ; Lai, Jinhuo ; Yi, Tienan ; Lin, Daren ; Yu, Yan ; Lu, Ping ; Li, Jinzhang ; Wang, Daqing ; Yang, Huaping ; Zhong, Diansheng ; Fang, Haohui ; Chen, Jianhua ; Zheng, Yulong ; Zhou, Ningning ; Wu, Rong ; Yu, Guohua ; Yang, Runxiang ; Gu, Kangsheng ; Ye, Xianwei ; Li, Baolan ; Xie, Chao ; Sun, Hong ; Zhang, Wei ; Chen, Hualin ; Xu, Xingxiang ; Zhang, Peng ; Wang, Zaiyi ; Cheng, Ying ; Hu, Qun ; Wu, Guowu ; Wu, Di ; Shi, Jianhua ; Wei, Shihong ; Li, Xingya ; Liu, Chunling ; Gu, Yuhai ; Xu, Yanhua
AbstractImmunochemotherapy is the first-line standard for extensive-stage small-cell lung cancer (ES-SCLC). Combining the regimen with anti-angiogenesis may improve efficacy. ETER701 was a multicenter, double-blind, randomized, placebo-controlled phase 3 trial that investigated the efficacy and safety of benmelstobart (a novel programmed death-ligand 1 (PD-L1) inhibitor) with anlotinib (a multi-target anti-angiogenic small molecule) and standard chemotherapy in treatment-naive ES-SCLC. The ETER701 trial assessed two primary endpoints: Independent Review Committee-assessed progression-free survival per RECIST 1.1 and overall survival (OS). Here the prespecified final progression-free survival and interim OS analysis is reported. Patients randomly received benmelstobart and anlotinib plus etoposide/carboplatin (EC; n = 246), placebo and anlotinib plus EC (n = 245) or double placebo plus EC (‘EC alone’; n = 247), followed by matching maintenance therapy. Compared with EC alone, median OS was prolonged with benmelstobart and anlotinib plus EC (19.3 versus 11.9 months; hazard ratio 0.61; P = 0.0002), while improvement of OS was not statistically significant with anlotinib plus EC (13.3 versus 11.9 months; hazard ratio 0.86; P = 0.1723). The incidence of grade 3 or higher treatment-related adverse events was 93.1%, 94.3% and 87.0% in the benmelstobart and anlotinib plus EC, anlotinib plus EC, and EC alone groups, respectively. This study of immunochemotherapy plus multi-target anti-angiogenesis as first-line treatment achieved a median OS greater than recorded in prior randomized studies in patients with ES-SCLC. The safety profile was assessed as tolerable and manageable. Our findings suggest that the addition of anti-angiogenesis therapy to immunochemotherapy may represent an efficacious and safe approach to the management of ES-SCLC. ClinicalTrials.gov identifier: NCT04234607.