Therapeutic approaches for small cell lung cancer: chemotherapy alone or immunochemotherapy?
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i3e-239350Keywords:
Outcomes, Immunotherapy, Chemotherapy, Small cell lung carcinomaAbstract
Lung cancer (LC) was considered the most common type of cancer in the world in 2022, accounting for 12.4% of all new cases, and is the leading cause of cancer death in particular, small cell lung cancer (SCLC) accounts for 15% of lung cancer cases and is characterized by its malignancy and rapid progression, with a high chance of progressing to metastasis. Therefore, this review aims to highlight the results of immunochemotherapy in the treatment of SCLC, compared to the use of chemotherapy alone, as a way of increasing overall survival (OS) and progression-free survival (PFS). This is an integrative literature review carried out using the PubMed database with a survey of 36 articles, using the descriptors Carcinoma Small-Cell Lung; Chemotherapy; Immunotherapy; and Outcomes; excluding Carcinoma non-small-cell lung, published free of charge between 2019 and 2024. In the end, 15 articles were selected for synthesis, using inclusion and exclusion criteria. Analysis of the selected studies shows that immunochemotherapy offers significant advances in the treatment of SCLC, especially for advanced-stage cases. The use of Serplulimab (anti-PD-1) associated with chemotherapy showed significant benefits in OS and PFS, especially in subgroups of patients with specific profiles. These data suggest an advantage in applying personalized treatments based on demographic and molecular characteristics. Among emerging strategies, Cadonilimab has enabled improvement in the immune response of CPPC, while Tarlatamab represents an advance among targeted immunotherapies, promoting a selective and direct immune response against the tumor. The studies also pointed out that although PD-1/PD-L1 inhibitors promote an improvement in survival, these regimens are accompanied by an increase in serious adverse events (AEs). Thus, immunochemotherapy represents a promising alternative for increasing survival and quality of life in patients with extensive-stage small cell lung cancer (ES-SCLC), although adverse events and high costs challenge its widespread application, highlighting the need to identify reliable biomarkers to guide patient selection and improve the cost-effectiveness of treatments.
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