Combined Small Cell Lung Cancer (C-SCLC) is a relatively rare type of lung cancer, which involves a combination of small cell carcinoma (SCLC) and any type of non-small cell lung cancer (NSCLC) histological components. The incidence of C-SCLC is increasing, with a higher proportion of affected patients being male and having a history of smoking. Currently, the diagnosis of C-SCLC is mainly based on pathology, and the most common pathological types of the coexisting non-small cell carcinoma components are squamous cell carcinoma and adenocarcinoma. Several studies have identified EGFR, TP53, and RB1 gene mutations, as well as high expression of YAP1, are potential biomarkers of C-SCLC. Treatment options for C-SCLC include surgery, chemotherapy, and radiotherapy in combination. For early-stage C-SCLC, surgical resection is the most effective method, while for patients in the middle or late stages who miss the surgical opportunity, chemotherapy and radiotherapy offer the most benefit. Currently, immunotherapy and targeted therapy show certain potential in the treatment of C-SCLC patients.
Objective To evaluate the efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced resectable non-small-cell lung carcinoma. Methods The clinical data of patients with non-small cell lung cancer (NSCLC) who received neoadjuvant immunotherapy combined with chemotherapy and surgery after chemotherapy alone from April 2021 to January 2021 in the first People's Hospital, Jining, were retrospectively analyzed. According to the preoperative neoadjuvant regimen, the patients were divided into a combination group and a chemotherapy group, and the clinical data of the two groups were compared. ResultsA total of 66 patients were enrolled, including 61 males and 5 females. There were 53 patients in the combination group with an average age of 63.40±6.80 years, and 13 patients in the chemotherapy group with an average age of 58.62±8.30 years. There was statistical difference in age between the two groups (P=0.02), but no statistical difference in other baseline data (P＞0.05). MPR was 54.7% in the combination group and 23.1% in the chemotherapy group (P=0.042), and PCR was 39.6% in the combination group and 0.0% in the chemotherapy group (P=0.006). The combined group had a shorter operative time (P=0.039). There were no statistical differences in intraoperative bleeding, postoperative tube-carrying time, postoperative complications, OS or EFS between the two groups. Conclusion Surgery after neoadjuvant immunotherapy is safe and feasible, and long-term efficacy should be confirmed by further follow-up.