使用抗程序性死亡配体1（PD-L1）免疫检查点抑制剂（ICIs）联合化疗一线治疗广泛期小细胞肺癌（SCLC）患者的真实临床经验很少见。报道称。在本研究中，我们旨在对接受抗 PD-L1 ICI 联合化疗一线治疗的广泛期 SCLC 患者进行回顾性多中心临床分析。根据林口、嘉义和高雄长庚医院癌症中心数据库，回顾性分析2018年11月至2022年3月期间接受一线atezolizumab或durvalumab联合化疗的72例广泛期SCLC患者。 21 名患者 (29.2%) 接受了 atezolizumab，51 名患者 (70.8%) 接受了 durvalumab。一线 ICI 加化疗的客观缓解 (OR) 率和疾病控制 (DC) 率分别为 59.7% 和 73.6%。所有研究患者的中位无进展生存期 (PFS) 为 6.63 个月（95% 置信区间 (CI)，5.25-8.02），中位总生存期 (OS) 为 16.07 个月（95% CI，15.12-17.0） 。在多变量分析中，高中性粒细胞与淋巴细胞比率（NLR；>4）和高血清乳酸脱氢酶（LDH）浓度（>260 UL）被确定为与较短 OS 相关的独立不利因素。关于安全性，中性粒细胞减少症是最常见的 3 级治疗相关不良事件 (AE)，但研究患者中没有发生治疗相关死亡。一线抗 PD-L1 ICI 联合化疗对于男性广泛期 SCLC 患者有效且安全。对于结局不良的患者（例如基线高 NLR 和血清 LDH 水平），可能需要制定进一步的治疗策略。

Real-world clinical experience of using anti-programmed death-ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs) combined with chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer (SCLC) patients has rarely been reported. In this study, we aimed to perform a retrospective multicenter clinical analysis of extensive-stage SCLC patients receiving first-line therapy with anti-PD-L1 ICIs combined with chemotherapy. Between November 2018 and March 2022, 72 extensive-stage SCLC patients receiving first-line atezolizumab or durvalumab in combination with chemotherapy, according to the cancer center databases of Linkou, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals, were retrospectively included in the analysis. Twenty-one patients (29.2%) received atezolizumab and fifty-one (70.8%) received durvalumab. Objective response (OR) and disease control (DC) rates of 59.7% and 73.6%, respectively, were observed with first-line ICI plus chemotherapy. The median progression-free survival (PFS) was 6.63 months (95% confidence interval (CI), 5.25-8.02), and the median overall survival (OS) was 16.07 months (95% CI, 15.12-17.0) in all study patients. A high neutrophil-to-lymphocyte ratio (NLR; >4) and a high serum lactate dehydrogenase (LDH) concentration (>260 UL) were identified as independent unfavorable factors associated with shorter OS in the multivariate analysis. Regarding safety, neutropenia was the most common grade 3 treatment-related adverse event (AE), but no treatment-related deaths occurred in the study patients. First-line anti-PD-L1 ICIs combined with chemotherapy are effective and safe for male extensive-stage SCLC patients. Further therapeutic strategies may need to be developed for patients with unfavorable outcomes (e.g., baseline high NLR and serum LDH level).