Adebrelimab Combine With Etoposide Capsules in ES-SCLC Maintenance Therapy

Exclusion Criteria

• •1. Limited-stage small cell lung cancer (SCLC);
• •2. Histologically or cytologically confirmed mixed histology SCLC;
• •3. Prior treatment with anti-angiogenic agents;
• •4. Conditions that may affect oral drug intake, such as inability to swallow, chronic diarrhea, or intestinal obstruction;
• •5. Major surgery, open biopsy, or significant traumatic injury within 4 weeks prior to enrollment;
• •6. Participation in another investigational drug clinical trial within 4 weeks prior to enrollment;
• •7. Relevant medical history:
• •(1)Untreated or symptomatic brain metastases or spinal cord compression; (2)Concurrent active malignancy requiring treatment; (3)Active autoimmune disease or immunodeficiency, or a history of such conditions, including but not limited to autoimmune hepatitis, interstitial lung disease, uveitis, rheumatoid arthritis, inflammatory bowel disease, hypophysitis, vasculitis, or nephritis.Exceptions include: patients with stable disease not requiring systemic immunosuppressive therapy, such as type I diabetes mellitus, hypothyroidism controlled with hormone replacement therapy, or skin disorders not requiring systemic treatment (e.g., vitiligo, psoriasis, or alopecia), or those with no external triggering factors and a low risk of recurrence; (4)History of psychiatric or substance abuse disorders that would interfere with study compliance; 8.Presence of any severe and/or uncontrolled comorbid conditions, including but not limited to:
• •1. Uncontrolled hypertension (systolic BP ≥150 mmHg or diastolic BP ≥100 mmHg);
• •2. Myocardial ischemia or infarction of grade I or higher, arrhythmias (including QTc ≥450 ms in males, ≥470 ms in females), congestive heart failure of NYHA class ≥2, or left ventricular ejection fraction (LVEF) \<50% on echocardiogram;
• •3. Decompensated diabetes mellitus or other contraindications requiring high-dose corticosteroids;
• •4. Exacerbation of chronic obstructive pulmonary disease (COPD) or other serious respiratory disorders requiring hospitalization;
• •5. Active or uncontrolled severe infection (≥CTCAE grade 2);
• •6. Uncontrolled pleural, pericardial, or peritoneal effusion requiring repeated drainage;
• •7. Liver cirrhosis, decompensated liver disease, active hepatitis, or chronic hepatitis requiring antiviral treatment;
• •8. Renal insufficiency: urine protein ≥++ on routine urinalysis and 24-hour urine protein \>1.0 g confirmed; 9.Severe infection within 4 weeks before the first dose, including but not limited to infectious complications, bacteremia, severe pneumonia requiring hospitalization, or infections requiring intravenous antibiotics, antifungals, or antivirals; or unexplained fever \>38.5°C during screening or prior to first dose; 10.Grade III-IV immune-related adverse events (irAEs) during the induction phase with PD-L1 inhibitors; 11.Active brain or leptomeningeal metastases at enrollment; Exception: patients who received prior treatment (e.g., radiotherapy) for brain or leptomeningeal metastases during or before induction and had stable disease on imaging for at least 4 weeks prior to enrollment, discontinued systemic steroid therapy (≤10 mg/day prednisone or equivalent) for more than 4 weeks, and are asymptomatic, may be eligible; 12.Patients deemed by the investigator to be unable or unlikely to comply with the study protocol, restrictions, or requirements.