Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 30;13(7):1585-1594.
doi: 10.21037/tlcr-24-128. Epub 2024 Jul 19.

Durvalumab plus platinum-etoposide chemotherapy for extensive-stage small cell lung cancer: a retrospective real-world study

Kazuhito Misawa  1   2 , Kageaki Watanabe  1 , Masahiro Seike  2 , Yukio Hosomi  1
Affiliations

Durvalumab plus platinum-etoposide chemotherapy for extensive-stage small cell lung cancer: a retrospective real-world study

Kazuhito Misawa et al. Transl Lung Cancer Res. .

Abstract

Background: Immune checkpoint inhibitor plus platinum-etoposide (PE) improved overall survival (OS) in patients with extensive-stage small cell lung cancer (ES-SCLC). While the CASPIAN trial demonstrated the efficacy of durvalumab plus PE, the clinical trial results may not be representative of the general, real-world population because clinical trials often have strict inclusion and exclusion criteria. We herein report the efficacy and safety of durvalumab plus PE in patients with ES-SCLC in real-world, clinical practice.

Methods: The present, monocentric, retrospective study evaluated patients with ES-SCLC or recurrent, limited-stage SCLC who received durvalumab plus PE between September 2020 and February 2023. The efficacy and incidence of adverse events (AEs) were also evaluated.

Results: The study included 40 patients, of whom 17 were elderly (age >70 years), and 15 had performance status (PS) 2 or 3. The median follow-up time was 13.0 months [95% confidence interval (CI): 8.0-22.2 months]. The objective response rate was 80.0% (95% CI: 63.1-91.6%), and the disease control rate was 88.6% (95% CI: 73.3-96.8%). The median progression-free survival (PFS) was 5.9 months (95% CI: 4.9-6.9), and the median OS was 25.4 months (95% CI: 4.6-46.2). Factors such as advanced age, poor PS, and presence of brain metastases were not associated with lower PFS and OS. Twenty-six patients (65.0%) experienced grade 3 or higher AEs, mainly hematological toxicity. AEs leading to treatment discontinuation occurred in three patients (8%).

Conclusions: Durvalumab plus PE in patients with ES-SCLC showed good efficacy and safety according to our real-world data, suggesting that this treatment is well tolerated in clinical practice, even in elderly patients and those with poor PS.

Keywords: CASPIAN; Small cell lung cancer (SCLC); durvalumab; immune checkpoint inhibitor (ICI); platinum-etoposide (PE).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-128/coif). K.W. received payment or honoraria for lectures and presentations from Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Chugai Pharmaceutical, Merck Biopharma, MSD, Novartis, Ono Pharmaceutical, Riken Genesis, Sysmex Corporation and Takeda. M.S. received grants or contracts from Taiho Pharmaceutical, Chugai Pharmaceutical, Eli Lilly, Nippon Kayaku, Kyowa Hakko Kirin and payment or honoraria for lectures and presentations from AstraZeneca, MSD, Chugai Pharmaceutical, Taiho Pharmaceutical, Eli Lilly, Ono Pharmaceutical, Bristol-Myers Squibb, Nippon Boehringer Ingelheim, Pfizer, Novartis, Takeda, Kyowa Hakko Kirin, Nippon Kayaku, Daiichi-Sankyo Company, Merck Biopharma, Amgen. Y.H. received payment or honoraria for lectures and presentations from AstraZeneca, Eli Lilly Japan, Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, Bristol-Myers Squibb, Kyowa Hakko Kirin, Nihon Kayaku, Takeda, Eisai, Novartis and Pfizer. The other author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PFS and OS in the entire cohort. (A) Kaplan-Meier graph of PFS in the 40 patients with durvalumab plus platinum-etoposide. (B) Kaplan-Meier graph of OS in the 40 patients with durvalumab plus platinum-etoposide. PFS, progression-free survival; CI, confidence interval; OS, overall survival.
Figure 2
Figure 2
PFS by patient background. (A) Kaplan-Meier graph of PFS in patients with durvalumab plus platinum-etoposide by age (age ≤70 years and age >70 years). (B) Kaplan-Meier graph of PFS of patients with durvalumab plus platinum-etoposide by PS (PS 0–1 and PS 2–3). CI, confidence interval; PS, performance status; PFS, progression-free survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Oronsky B, Reid TR, Oronsky A, et al. What's New in SCLC? A Review. Neoplasia 2017;19:842-7. 10.1016/j.neo.2017.07.007 - DOI - PMC - PubMed
    1. Rossi A, Di Maio M, Chiodini P, et al. Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: the COCIS meta-analysis of individual patient data. J Clin Oncol 2012;30:1692-8. 10.1200/JCO.2011.40.4905 - DOI - PubMed
    1. van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer. Lancet 2011;378:1741-55. 10.1016/S0140-6736(11)60165-7 - DOI - PubMed
    1. Paz-Ares L, Dvorkin M, Chen Y, et al. Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomised, controlled, open-label, phase 3 trial. Lancet 2019;394:1929-39. 10.1016/S0140-6736(19)32222-6 - DOI - PubMed
    1. Horn L, Mansfield AS, Szczęsna A, et al. First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer. N Engl J Med 2018;379:2220-9. 10.1056/NEJMoa1809064 - DOI - PubMed

LinkOut - more resources