Lurbinectedin Misses Survival Endpoint in Relapsed SCLC Trial
Durvalumab combined with etoposide/cisplatin or carboplatin (EP) improves overall survival versus EP alone in patients with extensive‑stage small‑cell lung cancer, and the addition of tremelimumab provides a numerical overall survival benefit.
This 3‑year follow‑up of the phase III CASPIAN trial reports that patients with treatment‑naïve extensive‑stage small‑cell lung cancer (ES‑SCLC) receiving durvalumab plus etoposide/cisplatin or carboplatin (EP) had a median overall survival (OS) of 12.9 months versus 10.5 months with EP alone (hazard ratio = 0.71, 95 % CI 0.60‑0.86). The 36‑month OS rate was 17.6 % versus 5.8 %. Durvalumab plus tremelimumab plus EP numerically improved OS versus EP (HR = 0.81, 95 % CI 0.67‑0.97) with a median OS of 10.4 months and a 36‑month OS rate of 15.3 %. At data cut‑off, 27 and 19 patients remained on durvalumab in the durvalumab‑EP and durvalumab‑tremelimumab‑EP arms, respectively, underscoring the durability of treatment and the established role of durvalumab‑EP as first‑line standard of care.
In ES‑SCLC, prognosis remains poor and durable therapeutic options are limited. These findings provide robust evidence that durvalumab plus EP achieves a sustained 3‑year OS benefit and support its use as standard first‑line therapy, potentially improving survival outcomes for a historically hard‑to‑treat population.
Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.
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