Dr. Ready on Selecting Between Frontline Atezolizumab and Durvalumab in ES-SCLC

Neal E. Ready, MD, PhD, head and neck oncologist, medical oncologist, Duke Health, professor of medicine, member of the Duke Cancer Institute, Duke University School of Medicine, discusses selecting between frontline chemotherapy plus atezolizumab (Tecentriq) or durvalumab (Imfinzi) in extensive-stage small cell lung cancer (ES-SCLC).

In March 2019, the FDA approved atezolizumab for use in combination with carboplatin and etoposide for the frontline treatment of patients with ES-SCLC. In March 2020, durvalumab in combination with etoposide plus either carboplatin or cisplatin was FDA approved for frontline use in patients with ES-SCLC.

Both regimens offer effective and tolerable frontline options for patients with ES-SCLC, Ready says. Moreover, comparative data are needed to determine whether a clinically meaningful difference in efficacy or toxicity exists between the regimens.

However, some differences in the inclusion criteria of the phase 3 studies that led to the FDA approvals of atezolizumab and durvalumab could be referenced during treatment selection, Ready explains. For example, if a patient with ES-SCLC in need of frontline therapy better fits the patient population included in one study vs another, they may be better suited to receive that regimen.

Ultimately, both regimens represent significant advancements in the treatment of patients with ES-SCLC because the field was stagnant for decades prior to these approvals, Ready concludes.