Dr Shields on Updates in Upfront Systemic Therapy in ES-SCLC

Misty D. Shields, MD, PhD, assistant professor, clinical medicine, Department of Medicine, Division of Hematology/Oncology, associate member, Experimental and Developmental Therapeutics, Indiana University School of Medicine, discusses systemic therapy updates for patients with extensive-stage small cell lung cancer (ES-SCLC).

At the 2023 IASLC World Conference on Lung Cancer, Dr Shields presented the latest updates in upfront systemic therapy for patients with ES-SCLC. One important study discussed at this meeting was the IMbrella A trial, Shields says. IMbrella A was an observational extension study of the phase 3 IMpower133 trial (NCT02763579), which evaluated atezolizumab (Tecentriq) or placebo plus carboplatin and etoposide in patients with treatment-naïve ES-SCLC. Patients from the atezolizumab arm of IMpower133 were eligible for enrollment in IMbrella A if they continued to receive atezolizumab after the study’s closure or were in survival follow-up after IMpower133 closed. At a median follow-up of 59.4 months (range, 0.0-72.6), the median OS in the atezolizumab arm of IMpower133 was 12.3 months (95% CI, 10.8-15.8). The median OS in the placebo arm of this study was 10.3 months (95% CI, 9.3-11.3) at a median follow-up of 26.4 months (range, 0.0-34.4).

Additionally, the combined 5-year OS rate in the IMpower133 and IMbrella A atezolizumab cohort was 12% (95% CI, 7%-17%).

Findings from the phase 3 ETER701 trial (NCT04234607) were also reported at the meeting. This trial evaluated the PD-L1 inhibitor benmelstobart (TQB2450) plus anlotinib (AL3818) and carboplatin/etoposide vs anlotinib plus placebo and carboplatin/etoposide vs placebo plus carboplatin/etoposide in patients with previously untreated ES-SCLC, Shields explains. In this trial, patients in the benmelstobart arm achieved a median OS of 19.32 months (95% CI, 14.23-not evaluable) vs 11.89 months (95% CI, 10.74-13.37) for those in the placebo plus carboplatin/etoposide arm. Additionally, the median progression-free survival was 6.93 months (95% CI, 6.18-8.25) in the benmelstobart arm vs 4.21 months (95% CI, 4.17-4.24) in the placebo plus carboplatin/etoposide arm.