| Objective To investigate the association between metabolic status and the efficacy of first-line treatment in patients with small cell lung cancer(SCLC). Methods We retrospectively analyzed data from ES-SCLC patients who received first-line therapy with immune checkpoint inhibitors(ICIs) plus platinum –etoposide at the Department of Respiratory Medicine, Gulou Hospital, Nanjing University Medical School, between December 2020 and December 2023. Baseline body mass index(BMI), serum albumin, lipid profiles, and their dynamic changes(△) from baseline were evaluated for correlations with treatment outcomes. Results A total of 90 patients were included. Compared with the disease control group(CR+PR+SD), the progressive disease(PD) group had significantly lower serum albumin and apolipoprotein AI levels(P<0.01), and higher NSE, CEA, and CYFRA 21-1 levels(P<0.001). Multivariate analysis demonstrated that low baseline NSE was independently associated with longer progression-free survival(PFS)(P=0.008). Dynamic analyses showed that patients in the PD group experienced greater decreases in △serum albumin and △apolipoprotein AI, as well as greater increases in △NSE, △CEA, and △CYFRA 21-1(all P<0.05). Furthermore, elevated △triglyceride and △apolipoprotein AI levels were significantly associated with longer PFS(P=0.005 and P=0.006, respectively). Conclusion Low NSE, high apolipoprotein AI, and elevated △apolipoprotein AI are associated with prolonged PFS, suggesting their potential as predictive biomarkers for first-line treatment efficacy in ES-SCLC. |
