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Adjuvant Durvalumab Significantly Extends Survival Among Patients With Limited-Stage Small Cell Lung Cancer
According to results from the phase 3 ADRIATIC trial, adjuvant durvalumab significantly extended survival compared to placebo among patients with limited-stage small cell lung cancer (SCLC).
In this double-blind, placebo-controlled trial, 530 patients who did not experience disease progression after standard concurrent platinum-based chemoradiotherapy were randomized to receive either 1500 mg of durvalumab (n = 264) or placebo (n = 266) every 4 weeks for up to 24 months. Patients were stratified based on disease stage and prophylactic cranial irradiation. Primary end points included median overall survival (OS) and median progression-free survival (PFS). A key secondary end point was safety.
At analysis, the median OS was 55.9 months in the durvalumab arm and 33.4 months in the placebo arm (hazard ratio [HR], 0.73; 98% confidence interval [CI] 0.54 to 0.98; P = .01). The median PFS was 16.6 months and 9.2 months, respectively (HR, 0.76; 97% CI, 0.59 to 0.98; P = .02). Grade 3/4 adverse events occurred in 24.4% of patients in the durvalumab arm and 24.2% of patients in the placebo arm. Adverse events led to treatment discontinuation in 16.4% and 10.6%, respectively. Adverse events led to death in 2.7% of patients in the durvalumab arm and 1.9% of patients in the placebo arm. Grade 3/4 pneumonitis or radiation pneumonitis occurred in 3.1% and 2.6% of patients, respectively.
As Ying Chen, MD, Jilin Cancer Hospital, Changchun, China, et al concluded, “Adjuvant therapy with durvalumab led to significantly longer overall survival and progression-free survival than placebo among patients with limited-stage small-cell lung cancer.”
Source:
Cheng Y, Spigel DR, Cho BC, et al. Durvalumab after chemoradiotherapy in limited-stage small-cell lung cancer. N Engl J Med. Published online: September 13, 2024. doi: 10.1056/NEJMoa2404873
