Results from an interim analysis of the phase III ADRIATIC study demonstrated that consolidation therapy after chemoradiotherapy with durvalumab extends survival in patients with limited-stage small-cell lung cancer (SCLC) compared to the current standard-of-care treatment of chemoradiotherapy alone. The research was presented by David R. Spigel, MD, and colleagues at the 2024 ASCO Annual Meeting (Abstract LBA5).
David R. Spigel, MD
About the Analysis
This analysis compared the outcomes in patients with stage I to III limited-stage SCLC assigned to receive durvalumab (n = 264) with patients who received placebo (n = 266). All patients had completed chemoradiotherapy within the previous 42 days. Some participants also received prophylactic cranial irradiation.
Key Findings
As of January 15, 2024, median overall survival was approximately 56 months in patients who received durvalumab and 33 months in patients who received placebo. Median progression-free survival was about 17 months for patients who received durvalumab compared to 9 months for patients who received placebo.
The 36-month overall survival rate was approximately 57% in the durvalumab group and 48% in the placebo group. The 24-month progression-free survival rate was about 46% in the durvalumab group and 34% in the placebo group.
The rate of severe side effects was the same in both groups—24%. About 16% of the participants in the durvalumab group stopped treatment because of side effects compared to 11% in the placebo group. About 38% of participants in the durvalumab group developed pneumonitis compared to 30% in the placebo group. The rate of grade 3 or 4 pneumonitis was similar between the two groups (3.0% in the durvalumab group and 2.6% in the placebo group).
“We have seen advances with immunotherapy in locally advanced unresectable and metastatic non–small cell lung cancer (NSCLC), and more recently, in early-stage resectable NSCLC. We’ve also seen advances in… metastatic SCLC. This is the first trial to show that immunotherapy helps patients with limited-stage, or nonmetastatic, SCLC,” said lead study author Dr. Spigel, Chief Scientific Officer at Sarah Cannon Research Institute in Nashville, Tennessee.
Next Steps
Researchers will continue to follow the study participants to evaluate if there are better results in patients receiving a combination of durvalumab and tremelimumab. They will also analyze different subsets to determine if there are any groups of patients with limited-stage SCLC that have better outcomes on these drugs.
ASCO Perspective
Lauren Byers, MD
“The standard treatment for patients with limited-stage SCLC has not changed significantly since the 1980s. In this trial, patients with this cancer who received the addition of immunotherapy after traditional chemotherapy and radiation lived longer and were less likely to have their cancer recur,” said Lauren Byers, MD, Professor and Thoracic Section Chief in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center.
Disclosure: This study was funded by AstraZeneca. For full disclosures of the study authors, visit coi.asco.org.
