Consolidation with durvalumab improves survival in LS-SCLC

In the phase 3 ADRIATIC trial, durvalumab significantly improved progression-free (PFS) and overall survival (OS) compared with placebo as a consolidation treatment in limited-stage small cell lung cancer (LS-SCLC), following concurrent chemoradiation therapy (cCRT).

The current standard-of-care for patients with LS-SCLC is cCRT, which results in a median OS of 25–30 months [1]. Previously, consolidation with durvalumab post-cCRT improved OS in non-small-cell lung cancer (NSCLC) [2]. The addition of durvalumab to first-line chemotherapy also improved OS in early-stage SCLC [3].

The phase 3 ADRIATIC trial (NCT03703297) evaluated durvalumab (±tremelimumab) consolidation therapy in patients with LS-SCLC who had not progressed following cCRT. The 530 participants were 1:1 randomised to receive durvalumab, every 4 weeks, or a placebo until progression or intolerable toxicity occurred for a maximum of 24 months. Dr David Spigel (Sarah Cannon Research Institute, TN, USA) presented the first results [4].

The median PFS was significantly improved with durvalumab consolidation therapy versus placebo (16.6 vs 9.2 months; HR 0.76; 95% CI 0.61–0.95; P=0.0161). In addition, durvalumab consolidation therapy improved median OS over placebo (55.9 vs 33.4 months; HR 0.73; 95% CI 0.57–0.93; P=0.0104). Results were generally consistent in all prespecified subgroups. The safety findings were in line with the known safety profile of durvalumab.

“Consolidation durvalumab will become the new standard-of-care for patients with LS-SCLC who have not progressed after cCRT,” concluded Dr Spigel.

1. Bogart J, et al. J Clin Oncol. 2023;41:2394-2402.
2. Antonia SJ, et al. N Engl J Med 2018;379:2342-2350.
3. Paz-Ares L, et al. Lancet. 2019;394:1929-1939.
4. Spigel DR, et al. ADRIATIC: durvalumab (D) as consolidation treatment (tx) for patients (pts) with limited-stage small-cell lung cancer (LS-SCLC). Abstract LBA5, ASCO Annual Meeting 2024, 31 May–4 June, Chicago, IL, USA.

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Posted on 18 July 202418 July 2024