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Purpose <p>To clarifythe efficacy and safety of neoadjuvant chemoimmunotherapy—now standard for resectable non-small-cell lung cancer—in patients with limited-stage small-cell lung cancer (LS-SCLC), a setting in which its benefit remains undefined.</p> Methods <p>Patients with LS-SCLC treated with chemoradiotherapy or neoadjuvant chemoimmunotherapy followed by surgery at Shanghai Pulmonary Hospital between December 2017 and December 2023 were retrospectively reviewed. Comprehensive demographic data, along with details of the therapy paradigm and surgical information, were meticulously retrieved.</p> Results <p>A total of 115 LS-SCLC patients were enrolled, with 33 treated with neoadjuvant chemoimmunotherapy followed by surgery and 82 with radical chemoradiotherapy. Pathology showed a 24.24% complete pathologic response (8/33) and 30.30% major pathologic response (10/33) in the neoadjuvant patients. Median overall survival (OS) was significantly improved in the neoadjuvant group (not reached) vs. chemoradiotherapy (27.13 months; HR 0.161 [95%CI 0.039–0.665]; <i>P</i> = 0.004). Subgroup analyses showed OS benefits with neoadjuvant chemoimmunotherapy plus surgery across subgroups. Furthermore, results were corroborated in the propensity score matching analysis. The most common treatment-related grade 3/4 adverse events were neutrophil count decreased (grade 3: 4 [12.12%]; grade 4: 6 [18.18%]). No perioperative death or other surgery-related adverse events were reported.</p> Conclusion <p>The combination of neoadjuvant chemoimmunotherapy demonstrated superior survival prolongation and acceptable safety in patients with LS-SCLC. Our results indicated the potential clinical feasibility of neoadjuvant chemoimmunotherapy plus surgery for selected localized SCLC.</p> Graphical Abstract <p></p>

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Neoadjuvant chemotherapy combined with immunotherapy in selected limited-stage small-cell lung cancer: a retrospective real-world study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月31日

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  • Wengang Zhang,
  • Wencheng Zhao,
  • Xuan Chen,
  • Xuyang Chen,
  • Li Ye,
  • Zhimin Chen,
  • Lihua Huang,
  • Kandi Xu,
  • Xinyue Liu,
  • Yayi He

摘要

Purpose

To clarifythe efficacy and safety of neoadjuvant chemoimmunotherapy—now standard for resectable non-small-cell lung cancer—in patients with limited-stage small-cell lung cancer (LS-SCLC), a setting in which its benefit remains undefined.

Methods

Patients with LS-SCLC treated with chemoradiotherapy or neoadjuvant chemoimmunotherapy followed by surgery at Shanghai Pulmonary Hospital between December 2017 and December 2023 were retrospectively reviewed. Comprehensive demographic data, along with details of the therapy paradigm and surgical information, were meticulously retrieved.

Results

A total of 115 LS-SCLC patients were enrolled, with 33 treated with neoadjuvant chemoimmunotherapy followed by surgery and 82 with radical chemoradiotherapy. Pathology showed a 24.24% complete pathologic response (8/33) and 30.30% major pathologic response (10/33) in the neoadjuvant patients. Median overall survival (OS) was significantly improved in the neoadjuvant group (not reached) vs. chemoradiotherapy (27.13 months; HR 0.161 [95%CI 0.039–0.665]; P = 0.004). Subgroup analyses showed OS benefits with neoadjuvant chemoimmunotherapy plus surgery across subgroups. Furthermore, results were corroborated in the propensity score matching analysis. The most common treatment-related grade 3/4 adverse events were neutrophil count decreased (grade 3: 4 [12.12%]; grade 4: 6 [18.18%]). No perioperative death or other surgery-related adverse events were reported.

Conclusion

The combination of neoadjuvant chemoimmunotherapy demonstrated superior survival prolongation and acceptable safety in patients with LS-SCLC. Our results indicated the potential clinical feasibility of neoadjuvant chemoimmunotherapy plus surgery for selected localized SCLC.

Graphical Abstract