Durvalumab Adjuvant Improves Survival in Small Cell Lung Cancer

On Thursday, September 19, 2024, a study published in the New England Journal of Medicine has revealed promising results for patients with limited-stage small cell lung cancer. The research, released online to coincide with the European Society for Medical Oncology's annual meeting held from September 13 to 17 in Barcelona, Spain, highlights the benefits of adjuvant therapy using durvalumab.

Dr. Ying Cheng from Jilin Cancer Hospital in Changchun, China, along with colleagues, led a phase 3 clinical trial focusing on patients with limited-stage small cell lung cancer who had completed standard concurrent platinum-based chemoradiotherapy without disease progression. The study involved 730 participants who were randomly divided into three groups. One group of 264 patients received durvalumab at a dose of 1,500 mg. Another group of 200 patients received a combination of durvalumab 1,500 mg and tremelimumab 75 mg for four doses. The third group, consisting of 266 patients, was given a placebo. These treatments were administered every four weeks for a duration of up to 24 months.

The first planned interim analysis of the study focused on comparing overall and progression-free survival between the durvalumab group and the placebo group. The findings were significant. Patients treated with durvalumab exhibited a median overall survival of 55.9 months compared to 33.4 months for those in the placebo group. This resulted in a hazard ratio for death of 0.73, indicating a 27% reduction in the risk of death for the durvalumab group. Additionally, the median progression-free survival was substantially longer for the durvalumab group at 16.6 months versus 9.2 months for the placebo group, with a hazard ratio for progression or death of 0.76.

Adverse events were noted and categorized by their severity. Among the patients receiving durvalumab, 24.4% experienced adverse events of maximum grade 3 or 4, compared to 24.2% of patients in the placebo group. Treatment discontinuation due to adverse events was reported in 16.4% of patients in the durvalumab group and 10.6% in the placebo group. Deaths due to adverse events were relatively low, at 2.7% for the durvalumab group and 1.9% for the placebo group.

The study concluded that adding durvalumab as an adjuvant therapy significantly improved both overall and progression-free survival for patients with limited-stage small cell lung cancer who had undergone definitive concurrent chemoradiotherapy. This marks a substantial advancement in the treatment of this aggressive form of lung cancer, providing new hope for patients.

Notably, several study authors disclosed connections to biopharmaceutical companies, including AstraZeneca. AstraZeneca is the manufacturer of durvalumab and provided the funding for this study.