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Research Article: First-line serplulimab plus chemotherapy versus chemotherapy alone in small-cell lung cancer patients with brain metastases: a multicenter, prospective cohort study

Date Published: 2026-06-08

Abstract:
Immunochemotherapy is standard for small-cell lung cancer (SCLC), yet efficacy and safety of serplulimab for patients with brain metastases (BM) remain to be fully elucidated in routine clinical practice. In this multicenter, prospective cohort study, SCLC patients with BM who received first-line serplulimab plus platinum-based chemotherapy or chemotherapy alone were included. Primary endpoint was intracranial progression-free survival (iPFS). Secondary endpoints included extracranial PFS, systemic PFS, overall survival (OS), tumor response, and safety. A total of 62 patients with SCLC and confirmed BM were included. Patients treated with serplulimab achieved an intracranial objective response rate of 78.57%. With a median follow-up of 22.17 months, serplulimab combined with chemotherapy demonstrated significant benefits across all survival outcomes. The serplulimab group demonstrated significantly prolonged median iPFS (8.93 vs. 6.37 months; log-rank P = 0.004) and OS (28.77 vs. 12.95 months; log-rank P < 0.001) compared with chemotherapy alone. Exploratory analyses revealed that the addition of cranial radiotherapy to immunotherapy significantly augmented survival benefits. Safety profiles were manageable, with no new safety signals identified. First-line serplulimab plus chemotherapy demonstrates robust intracranial efficacy and survival benefits with manageable safety in SCLC patients with BM. Integrating cranial radiotherapy appears to offer complementary clinical value, supporting this multimodal strategy as a viable therapeutic option.

Introduction:
Immunochemotherapy is standard for small-cell lung cancer (SCLC), yet efficacy and safety of serplulimab for patients with brain metastases (BM) remain to be fully elucidated in routine clinical practice.

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