First-Line Durvalumab Plus Platinum-Etoposide for Patients With Extensive-Stage Small Cell Lung Cancer
According to final efficacy and safety results from the phase 3b LUMINANCE trial, first-line durvalumab plus platinum-etoposide demonstrated promise among patients with extensive-stage small cell lung cancer (SCLC).
These results were presented by Natasha Leighl, MD, Princess Margaret Cancer Centre, Toronto, Ontario, Canada, at the European Lung Cancer Congress in Paris, France.
In this study, 152 patients received 1500 mg of durvalumab plus platinum-etoposide once every 3 weeks for ≤ 6 cycles followed by durvalumab once every 4 weeks until disease progression or unacceptable toxicity. The primary end point was safety. Key secondary end points included progression-free survival (PFS) and overall survival (OS). Exploratory biomarker analyses were conducted to assess PFS and OS among eligible ctDNA evaluable patients (n = 148) with high tumor methylated fraction (n = 74), and CD8-evaluable patients (n = 76) with high CD8 density (n = 38).
At a median follow-up of 11.6 months, 13.2% of patients were still receiving durvalumab. Patients received a median of 9 doses of durvalumab and 48.7% of patients received 6 cycles of platinum-etoposide. Grade ≥3 adverse events were observed in 59.9% of patients and grade 3/4 immune-related adverse events were observed in 3.9% of patients. Median PFS was 6.3 months with a 12-month PFS rate of 15%. Median OS was 16.4 months with a 12-month OS rate of 59.8% and an 18-month OS rate of 43.9%.
In all ctDNA evaluable patients, median PFS was 6.6 months and 5.7 months for patients with high tumor methylated fraction. Median OS was 20.4 months and 10.1 months, respectively. In all CD8-evaluable patients, median PFS was 6.5 months and 6.2 months for patients with high CD8 density. Median OS was 17.4 months and 10.3 months, respectively.
“These results further support the use of [first-line durvalumab] for ES-SCLC,” concluded Dr Leighl et al. “Though limited by a lack of a control arm, PD-L1, MHC I and CD8 analyses were consistent with CASPIAN; ctDNA data support further investigation of the potential of TMeF as a biomarker in SCLC.”
Source:
Leighl N, Özgüroglu M, Longo V, et al. First-line (1L) durvalumab (D) + platinum-etoposide (EP) in extensive-stage SCLC (ES-SCLC): Final results and exploratory biomarker analyses from LUMINANCE. Presented at the 2025 European Lung Cancer Congress. Paris, France. Abstract 299P
