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Efficacy and safety of immunotherapy combined with chemoradiotherapy in limited-stage small cell lung cancer: a systematic evaluation and meta-analysis of randomized controlled trials

In brief

Immunotherapy with chemoradiotherapy reduces death risk 15% in limited-stage small cell lung cancer

A meta-analysis of nine randomized trials involving 1,853 patients found that adding immunotherapy to concurrent chemoradiotherapy lowered the hazard of death by roughly 15% and modestly improved progression-free survival, with the greatest benefit seen when immunotherapy was given as consolidation. The combined regimen was generally well tolerated, but longer-term safety and optimal timing remain to be clarified.

Journal
Frontiers in immunology (Q1)
Published
22 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Yixuan Wang, Yiyan Liu, Ning Zhan, Ke Jin, Lishuang Qi, Shilong Liu
PMID
42558713
DOI
10.3389/fimmu.2026.1731036

Why clinicians should know about it

Abstract

BACKGROUND: Concurrent chemoradiotherapy (cCRT) remains the standard treatment for patients diagnosed with limited-stage small-cell lung cancer (LS-SCLC); however, recurrence rates remain high and prognosis remains poor. This study collected data regarding patient-reported outcomes and adverse events (AEs) to evaluate the effects of chemoradiotherapy combined with immunotherapy in patients with LS-SCLC. METHODS: A systematic literature search of 7 electronic databases was conducted for randomized, placebo-controlled trials enrolling patients diagnosed with LS-SCLC who received chemoradiotherapy combined with immunotherapy. Trials with unstratified LS-SCLC samples were excluded. A subsequent meta-analysis was performed. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under accession number CRD42024607159. RESULTS: Nine trials comprising 1,853 patients were included. CCRT combined with immunotherapy exhibited a significant favorable trend in survival outcomes, with hazard ratios (HRs) for median progression-free survival (mPFS) and median overall survival (mOS) of 0.838 (95% confidence interval [CI]: 0.742-0.947) and 0.847 (95% CI: 0.736-0.975), especially in the consolidation group with HRs for mPFS and mOS of 0.793 (95% CI: 0.675-0.930) and 0.757 (95% CI: 0.551-1.040), respectively. CONCLUSION: CCRT combined with immunotherapy improved survival in patients with LS-SCLC, especially in the consolidation immunotherapy group. The treatment regimen was generally well tolerated, with an acceptable incidence of treatment-related adverse events (TRAEs). SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42024607159.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.