我们的研究旨在评估一线免疫检查点抑制剂(ICIs)与依托泊苷铂(EP)治疗广泛期小细胞肺癌(ES-SCLC)的有效性，并确定预后因素，因为实际世界的结果和PD-1和PD-L1抑制剂的不一致性不确定。我们选择了三个中心的ES-SCLC患者，并进行了倾向性评分匹配分析。使用Kaplan-Meier方法和Cox比例风险回归进行比较生存结果。我们还进行了单变量和多变量Cox回归分析，以研究预测因子。在包括236名患者中，匹配了83对病例。EP加ICI队列的中位总生存期(OS)比EP队列(13.4个月)更长(17.3个月) (危险比[HR]，0.61 [0.45,0.83]；p=0.001)。EP加ICI队列的中位无进展生存期(PFS)也比EP队列(5.9个月)更长(8.3个月)(HR，0.44 [0.32,0.60];p<0.001)。EP加ICI组的客观缓解率(ORR)更高(EP: 62.3%, EP+ICIs: 84.3%，p<0.001)。多元分析表明，肝转移(HR，2.08; p=0.018)和淋巴细胞/单核细胞比率(LMR) (HR，0.54; p=0.049)是OS的独立预后因子，而治疗反应评估(PS) (HR，2.11; p=0.015)，肝转移(HR，2.64; p=0.002)和中性粒细胞/淋巴细胞比率(NLR) (HR，0.45; p=0.028)是化疗免疫治疗患者的PFS预后因素。我们的实际世界数据表明，ICIs与化疗作为ES-SCLC的一线治疗设置是有效和安全的。 PS，肝转移和炎性标志物可能作为有价值的风险因子。©2023年作者。《胸腔肿瘤》由中国肺癌学组和约翰威利和儿子澳大利亚有限公司出版。

Our research aimed to evaluate the effectiveness of first-line immune checkpoint inhibitors (ICIs) with etoposide and platinum (EP) for extensive-stage small cell lung cancer (ES-SCLC) and identify prognostic factors, as real-world outcomes and the inconsistency of PD-1 and PD-L1 inhibitors are uncertain.We selected ES-SCLC patients in three centers and conducted a propensity score-matched analysis. The Kaplan-Meier method and Cox proportional hazards regression were conducted to compare the survival outcomes. We also performed univariate and multivariate Cox regression analyses to investigate predictors.Among 236 patients included, 83 pairs of cases were matched. The EP plus ICIs cohort had a longer median overall survival (OS) (17.3 months) than the EP cohort (13.4 months) (hazard ratio [HR],  0.61 [0.45, 0.83]; p = 0.001). The median progression-free survival (PFS) was also longer in the EP plus ICIs cohort (8.3 months) than in the EP cohort (5.9 months) (HR,   0.44 [0.32, 0.60]; p < 0.001). The EP plus ICIs group had a higher objective response rate (ORR) (EP: 62.3%, EP + ICIs: 84.3%, p < 0.001). Multivariate analysis presented that liver metastases (HR, 2.08; p = 0.018) and lymphocyte-monocyte ratio (LMR) (HR, 0.54; p = 0.049) were independent prognostic factors for OS, and performance status (PS) (HR, 2.11; p = 0.015), liver metastases (HR, 2.64; p = 0.002), and neutrophil-lymphocyte ratio (NLR) (HR, 0.45; p = 0.028) were for PFS in patients with chemo-immunotherapy.Our real-world data demonstrated that ICIs with chemotherapy as the first-line setting for ES-SCLC are effective and safe. PS, liver metastases, and inflammatory markers could serve as valuable risk factors.© 2023 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.