Dr. Rodriguez on the Role of Immunotherapy in ES-SCLC

Estelamari Rodriguez, MD, MPH, associate director of Community Outreach at Sylvester Comprehensive Cancer Center within the University of Miami Health System, discusses the role of immunotherapy in extensive-stage small cell lung cancer (ES-SCLC).

The phase 3 IMpower133 (NCT02763579) and CASPIAN (NCT03043872) trials, which examined chemotherapy with or without atezolizumab (Tecentriq) and durvalumab (Imfinzi) with or without tremelimumab plus chemotherapy, respectively, proved that immunotherapy has a role in the first-line setting for this patient population, according to Rodriguez. Results from both trials showed that patients who received immunotherapy in the form of either atezolizumab or durvalumab, experienced better outcomes.

Additionally, although the design of the trials differed, both yield a median overall survival of approximately 12 to 13 months with immunotherapy plus chemotherapy, compared with 10 months with chemotherapy alone, Rodriguez says. The trials also reported similar hazard ratios.

No differences in efficacy were observed based on PD-L1 expression or tumor microenvironment in these trials, so these regimens can be given to all patients with ES-SCLC, Rodriguez adds. Notably, less immune-related adverse effects were observed on the CASPIAN trial vs the IMpower133 trial, although this is thought to be due to the trial design rather than the regimen itself, according to Rodriguez. Currently, both study regimens are feasible options for patients with ES-SCLC, Rodriguez concludes.