‘Very Clear Signal’ That Survival Improved With Addition of Durvalumab in SCLC

The phase III ADRIATIC trial showed that adding consolidation treatment with durvalumab (Imfinzi) after concurrent chemoradiotherapy significantly improved progression-free and overall survival in patients with limited-stage small cell lung cancer (SCLC), as reported at the recent American Society of Clinical Oncology (ASCO) meeting.

In this exclusive MedPage Today video, Lauren Byers, MD, of MD Anderson Cancer Center in Houston, discusses the results of the study and the next steps moving forward.

Following is a transcript of her remarks:

In the ADRIATIC study, the investigators looked at whether or not adding immunotherapy following traditional chemotherapy with radiation improved patients’ outcomes. This really, based on the results, is a landmark study because there have not been really any major changes to how we treat patients with early-stage small cell lung cancer in about 40 years. And so in this trial, there was a very clear signal that patients’ survival improved with the addition of durvalumab after chemoradiation.

And so I think this is important for a couple of reasons. First, the fact that this will change the standard of care for patients, but also the magnitude of benefit was quite significant. So, on average, patients survived about 2 years longer with the addition of the immunotherapy as compared to patients who received placebo.

While this is a big step forward, I think the next steps are going to be to understand better who are those patients who are getting the most benefit. So in our work, we’ve demonstrated that similar to other types of lung cancer, small cell lung cancer is actually several different subtypes. And we’ve identified a group of patients that in previous trials seem to get relatively more benefit from the addition of immunotherapy.

And so I think one question going forward is, can we figure out who are the patients with these early-stage disease cancers who are getting the most benefit with the treatment with immunotherapy? And then, for patients who maybe are not getting as much benefit from the traditional immunotherapy approach, how are ways that we can further enhance their response through more personalized treatments?

So there are several clinical trials going on currently looking at different ways to approach this. All of those at this moment are still kind of a one-size-fits-all where everybody is receiving the same treatment, but they are incorporating newer approaches, including a T-cell engager, for example, which is targeting a cancer surface target called DLL3 [delta-like ligand 3] to bring the immune cells to the cancer, as well as additional combinations of immunotherapies together or in combination with targeted therapy.

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