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

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. 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. 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%. Adebrelimab-based therapy demonstrated promising real-world effectiveness and a manageable safety profile in patients with ES-SCLC.