Analyzing Outcomes of Immune Checkpoint Blockade Plus Chemo in SCLC

Ashish Saxena, MD, assistant professor of medicine at Weill Cornell Medicine, explains the outcomes of the addition of immune checkpoint blockade to standard chemotherapy for patients with metastatic small cell lung cancer (SCLC).

According to Saxena, there was a modest survival benefit demonstrated when investigators added immune checkpoint blockade therapy to standard chemotherapy in patients with metastatic SCLC.

Specifically in the metastatic setting, some recent studies have analyzed the addition of PD-L1 inhibitors, such as atezolizumab (Tecentriq) and durvalumab (Imfinzi). Both agents have improved overall survival and progression-free survival when given with chemotherapy. While there were good disease control rates seen in patients with SCLC with this combination, Saxena highlights that the benefits are overall modest, and further research must further investigate options that will improve on the benefits of immunotherapy.

Transcription:

0:08 | In the metastatic setting, there have been studies that have shown that adding immune checkpoint blockade, specifically, the PD-L1 inhibitors, atezolizumab or durvalumab, have improved overall survival and progression-free survival. These are given together with chemotherapy starting with the first cycle. Some patients have very good disease control with these, but the benefits overall are modest. Adding something more to that would hopefully further improve on the benefits of immunotherapy.

0:49 | I'm adding other treatments that are being looked at. Some of these are other drugs targeting different immune checkpoints or other mechanisms that might be sensitive in small cell lung cancer, but the addition of radiation is attractive because we do use radiation a lot in small cell lung cancer. Small cell lung cancer has felt to be very radio sensitive. In addition, adding radiation in other tumor types has shown to enhance the immunogenicity of the tumor and induce immune mediated cell killing. The idea of combining that with immunotherapy is something that's very attractive.