Durvalumab in combination with chemotherapy shows promise for patients with SCLC and poor performance status

Durvalumab combined with chemotherapy demonstrated acceptable toxicity and tolerability, with an initial survival benefit observed in patients with extensive-stage small cell lung cancer (SCLC) with poor performance status (PS).

Prof. Satoshi Watanabe (Niigata University, Japan) presented the results of the NEJ045A phase 2, open-label trial assessing durvalumab plus carboplatin and etoposide in adults aged ≥20 years with extensive-stage SCLC and PS 2 or 3 [1,2]. Chemotherapy (reduced dose for PS 3) was administered together with durvalumab for 4 cycles, followed by durvalumab monotherapy. The primary endpoint was tolerability. In total, the study included 43 participants with PS 2 and 13 participants with PS 3.

A third of participants with PS 2 and half of PS 3 completed induction therapy. The most common Grade 3 or higher adverse events were haematological, and 41% of participants required primary granulocyte colony-stimulating factor (G-CSF) prophylaxis. In terms of efficacy, the median progression-free survival was 4.8 and 4.6 months in participants with PS 2 and 3, respectively, while the median overall survival (OS) was 11.3 and 5.1 months, respectively. This corresponds to a 1-year OS of 50% and 18.2% for PS 2 and PS 3, respectively.

“Durvalumab plus carboplatin and etoposide demonstrated good tolerability with encouraging 1-year survival and OS outcomes,” concluded Prof. Watanabe. “These findings support the integration of PD-L1 inhibitors with chemotherapy for this challenging patient population.”

1. Asao T, et al. Durvalumab, carboplatin, and etoposide in treatment-naïve patients with extensive-stage small cell lung cancer and poor performance status: A single-arm phase II NEJ045A study. ERS Congress, 27 September–1 October 2025, Amsterdam, the Netherlands.
2. Asao T, et al. BMC Cancer. 2022;22:1135.

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Posted on 30 October 202530 October 2025