Durvalumab: A Review in Limited-Stage Small Cell Lung Cancer

Durvalumab (Imfinzi^®) is a monoclonal antibody directed against programmed cell death-ligand 1 (PD-L1) and the first immunotherapy approved for patients with limited-stage small cell lung cancer (LS-SCLC). In the USA, durvalumab is approved for use as monotherapy for the treatment of adults whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy (cCRT). In the EU and most other countries where durvalumab is also approved for use as monotherapy for the treatment of adults with LS-SCLC, the approvals do not specify that chemotherapy and radiation therapy be administered concurrently. In the phase III ADRIATIC trial, consolidation intravenous durvalumab every 4 weeks for up to 24 months was associated with significantly longer overall survival and progression-free survival compared with placebo in patients with LS-SCLC whose disease had not progressed following cCRT. Benefit from durvalumab was seen regardless of prior cCRT components and prophylactic cranial irradiation use. The tolerability and safety profile of durvalumab was manageable. Current evidence from ADRIATIC supports the use of consolidation therapy with durvalumab as a new standard of care in patients with LS-SCLC whose disease has not progressed following cCRT.