Shrestha on Updates to the SCLC Treatment Landscape

Sagun Shrestha, MD, medical director of medical oncology at City of Hope Phoenix, discusses new trials that are exploring anti PD-1 therapy in the first-line setting for patients with small cell lung cancer (SCLC).

In a setting that just a few years ago had very limited options, multiple treatments are now available for patients with SCLC. This includes the approval of the immune checkpoint inhibitors (ICIs) atezolizumab (Tecentriq), and durvalumab (Imfinzi).

These 2 ICIs were approved in 2019 and 2020, respectively, in combination for patients with extensive-stage SCLC based on findings from the IMpower133 trial (NCT02763579) and CASPIAN study (NCT03043872). Each of these agents have provided patients with an improvement in overall survival and have also decreased the chance of recurrence over time.

Though these developments have moved the needle for patients with extensive-stage SCLC, Shrestha highlights the unmet need for FDA-approved agents for the treatment of patients with early-stage SCLC. Studies remain ongoing in this space, however, none have been approved by the FDA to date.

Transcription:

0:10 | There have been several studies going on, but none of them have been FDA-approved yet for early-stage small cell lung cancer. There is the CASPIAN trial with immunotherapy, and the addition of pembrolizumab [Keytruda]. Even now, we can add pembrolizumab as 1 of the other immune checkpoint inhibitors, but we still prefer the atezolizumab and durvalumab at the present time. All of them are showing improvements in overall survival, and a decrease in disease-free progression has been improved by adding immunotherapy.

0:59 | The CASPIAN trial is 1 which is promising, but all of the drugs equally have a competitive response rate, especially in terms of using them as a maintenance drug. I think that changes how we are or how we have been treating extensive-stage small cell lung cancer.