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Addition of Toripalimab to First-Line Chemotherapy Improves Survival for Patients With Extensive-Stage Small Cell Lung Cancer
According to results from the phase 3 EXTENTORCH trial, the addition of toripalimab to first-line chemotherapy significantly improved survival among patients with extensive-stage small cell lung cancer (SCLC).
This multicenter, placebo-controlled trial enrolled 442 patients with extensive-stage SCLC who had not undergone prior systemic antitumor therapy. Patients were randomized on a 1-to-1 basis to receive either 240 mg of toripalimab (n = 223) or placebo (n = 219), plus etoposide and platinum-based chemotherapy every 3 weeks for 4 to 6 cycles. This was followed by maintenance toripalimab or placebo for up to 2 years, or until disease progression or unacceptable toxicity. The primary end point was investigator-assessed progression-free survival (PFS) and overall survival (OS). A key secondary end point was safety.
At a median follow-up of 13.7 months, toripalimab improved investigator-assessed PFS (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.54 to 0.82; P < .001) and significantly reduced the risk of death (HR, 0.80; 95% CI, 0.65 to 0.98; P = .03) compared to placebo. The median OS was 14.6 months in the toripalimab arm and 13.3 months in the placebo arm. No new safety signals were observed. Grade ≥3 treatment-emergent adverse events occurred in 89.6% of patients in the toripalimab arm and 89.4% of patients in the placebo arm.
As study authors concluded, results support “this combination regimen as a new treatment option for patients with ES-SCLC.”
Source:
Cheng Y, Zhang W, Wu L, et al. Toripalimab plus chemotherapy as a first-line therapy for extensive-stage small cell lung cancer. JAMA Oncol. Published online: November 14, 2024. doi:10.1001/jamaoncol.2024.5019
