一线免疫检查点抑制剂加化疗在治疗广泛期小细胞肺癌（ES-SCLC）患者的疗效和安全性尚未得到评估，没有直接比较不同免疫疗法（尤其是adebrelimab和serplulimab）疗效和安全性的报告。包括两个或更多不同组的适当第III期随机对照试验。独立审阅者筛选和提取相关数据，通过共识解决争议。采用固定效应一致性模型计算临床相关亚组中的总生存期（OS），无进展生存期（PFS），客观应答率，不良事件≥3和安全性结果。在这个网络荟萃分析中，涉及六项随机对照临床试验（CAPSTONE-1，ASTRUM-005，CASPIAN，IMpower133，KEYNOTE-604和一项ipilimumab +化疗试验），共有3662名患者。与化疗相比，免疫检查点抑制剂加化疗具有更高的OS和PFS改善可能性。与ipilimumab +化疗相比，serplulimab +化疗明显表现出更好的生存效益（0.67；0.50-0.90）。与化疗相比，adebrelimab +化疗（0.72；0.58-0.90），atezolizumab +化疗（0.76；0.60-0.96），durvalumab +化疗（0.75；0.62-0.91）和serplulimab +化疗（0.63；0.49-0.82）均表现出显著的更好的总生存期。在无进展生存期方面，serplulimab +化疗相对于adebrelimab +化疗（0.72；0.53-0.97），atezolizumab +化疗（0.62；0.46-0.84），durvalumab +化疗（0.60；0.45-0.80）表现出更好的疗效。与化疗相比，adebrelimab +化疗（0.67；0.54-0.83）和serplulimab +化疗（0.48；0.48-0.86）均表现出显著更好的PFS。免疫疗法加化疗具有引起≥3级不良事件的类似概率。与化疗相比，一线免疫检查点抑制剂加化疗更适合ES-SCLC的治疗。根据我们的分析，serplulimab加化疗和adebrelimab加化疗均有更高的可能性表现出更好的疗效和安全性，但是这种比较的证据水平有限。版权所有©2023年作者。Elsevier B.V.发表，版权所有。

The efficacy and safety of first-line immune checkpoint inhibitors plus chemotherapy in the treatment of patients with extensive-stage small cell lung cancer (ES-SCLC) remains unevaluated, and there are no reports to directly compare the efficacy and safety among different immunotherapy (especially adebrelimab and surplulimab). Suitable phase III randomized controlled trials with two or more different arms were included. Independent reviewers screened and extracted relevant data and disagreements were resolved through consensus. Fixed-effect consistency models were used to calculate the overall survival (OS), progression-free survival (PFS), objective response rate, adverse events ≥ 3, and safety outcomes in the clinically relevant subgroups. In this network meta-analysis, six randomized controlled clinical trials (CAPSTONE-1, ASTRUM-005, CASPIAN, IMpower133, KEYNOTE-604, and an ipilimumab + chemotherapy trial) with totaling 3662 patients were involved. Compared to chemotherapy, immune checkpoint inhibitors plus chemotherapy present higher possibilities to bring about better OS and PFS. Serplulimab + chemotherapy significantly showed a better survival profit in comparison with ipilimumab + chemotherapy (0.67; 0.50-0.90). Compared with chemotherapy, adebrelimab + chemotherapy (0.72; 0,58-0.90), atezolizumab + chemotherapy (0.76; 0.60-0.96) durvalumab + chemotherapy (0.75; 0.62-0.91), and serplulimab + chemotherapy (0.63;0.49-0.82) all presented significantly better overall survival. In terms of progression-free survival, serplulimab + chemotherapy showed better efficacy in comparison with adebrelimab + chemotherapy (0.72; 0,53-0.97), atezolizumab + chemotherapy (0.62; 0.46-0.84), durvalumab + chemotherapy (0.60; 0.45-0.80). Compared with chemotherapy, adebrelimab + chemotherapy (0.67; 0.54-0.83) and serplulimab + chemotherapy (0.48; 0.48-0.86) all presented significantly better PFS. Immunotherapy plus chemotherapy had similar probabilities to cause adverse events of grade ≥ 3. In comparison with chemotherapy, immune checkpoint inhibitors plus chemotherapy were likely to be more suitable for the first-line treatment of ES-SCLC. According to our analysis, serplulimab plus chemotherapy and adebrelimab plus chemotherapy present higher possibilities to show better efficacy and safety, however, the level of evidence of this type of comparison is limited.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.