A retrospective study found that chemoimmunotherapy, compared to chemotherapy alone, led to a longer progression-free survival (PFS) in patients with extensive-stage small cell lung cancer (SCLC) and an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or 3. Although the difference in overall survival (OS) did not reach statistical significance, the small study cohort may have limited the power to detect a significant benefit. The researchers concluded that clinicians should consider chemoimmunotherapy for these patients and emphasized the need for further research with a larger study size to evaluate its potential impact on OS. Previous studies have demonstrated improved outcomes with chemoimmunotherapy for extensive-stage SCLC patients with an ECOG performance status of 0 or 1, but evidence for its benefit in patients with a performance status of 2 or 3 has been limited. The study reviewed the outcomes of 46 adults with extensive-stage SCLC and poor performance status treated at Mayo Clinic. Among them, 26 patients received platinum-etoposide and atezolizumab (Tecentriq), while the other 20 received platinum-etoposide alone. The chemoimmunotherapy group showed a modest but statistically significant improvement in PFS compared to chemotherapy alone. Although the median OS was numerically longer with chemoimmunotherapy, the difference did not reach statistical significance. Overall, this study suggests that chemoimmunotherapy may be a viable treatment option for extensive-stage SCLC patients with poor performance status, but further research is needed to confirm its benefits on overall survival.

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