What do systematic reviews say?

First‐line chemotherapy vs BSC

• Chemotherapy versus best supportive care for extensive small cell lung cancer 2013 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 65 participants
  Very low

Intervention not reported

The intervention may leads to lower overall survival (low certainty).

• Chemotherapy versus best supportive care for extensive small cell lung cancer 2013 · Cochrane Headline outcomes only
  HR 0.73 [0.55, 0.96]
  2 studies · 542 participants
  Low

Single‐immune checkpoint inhibitors (ICIs) vs chemotherapy alone

Single‐immune checkpoint inhibitors (ICIs) probably leads to lower overall survival (OS) compared with chemotherapy (moderate certainty).

• Single or combined immune checkpoint inhibitors compared to first‐line platinum‐based chemotherapy with or without… 2021 · Cochrane Headline outcomes only
  HR 0.68 [0.6, 0.76]
  6 studies · 2111 participants
  Moderate

Combined immune checkpoint inhibitors (ICIs) vs chemotherapy alone

Combined immune checkpoint inhibitors (ICIs) probably leads to lower overall Survival (OS) compared with chemotherapy (moderate certainty).

• Single or combined immune checkpoint inhibitors compared to first‐line platinum‐based chemotherapy with or without… 2021 · Cochrane Headline outcomes only
  HR 0.72 [0.59, 0.89]
  2 studies · 612 participants
  Moderate

Afatinib vs chemotherapy alone

Afatinib showed no clear difference in overall survival compared with chemotherapy (high certainty).

• First‐line treatment of advanced epidermal growth factor receptor (EGFR) mutation positive non‐squamous non‐small cell… 2021 · Cochrane Headline outcomes only
  HR 0.91 [0.75, 1.1]
  2 studies · 709 participants
  High