First-line durvalumab plus platinum-etoposide in Japanese patients with extensive-stage small-cell lung cancer

Platinum-based chemotherapy combined with immune checkpoint inhibitor therapy has recently been introduced for treating extensive-stage small-cell lung cancer (ES-SCLC). In the Phase III CASPIAN study, first-line etoposide (Etoposide) with cisplatin / carboplatin (EP) plus durvalumab significantly improved survival in patients with ES-SCLC. However, it included few Japanese patients, underscoring the need for evaluating the efficacy and safety of this treatment specifically in the Japanese population.

Patients with treatment-naïve ES-SCLC were retrospectively investigated at eight hospitals in Japan, between August 1, 2020 and December 31, 2023. They received EP plus durvalumab (four cycles) every 3 weeks, followed by maintenance durvalumab every 4 weeks until disease progression. The primary endpoint was safety, while the secondary endpoints were overall survival, progression-free survival, objective response rate, and disease control rate.

Sixty-nine patients aged 48-91 years (median: 72 years) were included. Most had an Eastern Cooperative Oncology Group performance status of 0 or 1. Grade ≥3 adverse events occurred in 72.5 % of patients and immune-related adverse events in 21.7 %. The median overall survival was 15.0 months (95 % confidence interval: 11.6-20.0), while the median progression-free survival was 5.0 months (95 % confidence interval: 4.3-5.8). Objective response and disease control rates were 75.4 % and 92.8 %, respectively.

First-line EP plus durvalumab was effective and well tolerated in Japanese patients with ES-SCLC in a real-world setting aligning with findings of global studies. This regimen should be considered the standard of care for Japanese patients with ES-SCLC.