OnCo
trialsTrialPositive

CASPIAN

Confirmed that adding a PD-L1 blocker to first-line chemotherapy helps in small-cell lung cancer, and showed that adding a second immunotherapy did not help further.

Durvalumab + platinum-etoposide: OS 13.0 vs 10.3 months (HR 0.73); 3-year OS 17.6% vs 5.8%. Adding tremelimumab did not improve OS. Allowed cisplatin or carboplatin and up to six cycles of chemotherapy in the control arm. FDA approval March 2020.

Setting
First-line extensive-stage SCLC: platinum-etoposide + durvalumab (± tremelimumab) vs platinum-etoposide
Phase
Phase 3
Sponsor
AstraZeneca
Registry
NCT03043872
Headline result
OS 13.0 vs 10.3 months, HR 0.73; 3-year OS 17.6% vs 5.8%.
Reported
2019
Enrolled
805
Replication
Consistent with IMpower133; the durvalumab-tremelimumab arm's failure was itself replicated by other CTLA-4 add-on attempts in SCLC.

Outcomes

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In plain words
What these results mean for people, not percentages
805 people took part
Overall survivalprimarysurvival endpoint
  • Median 13 vs 10.3 months with Durvalumab + EP compared with EP alone; about 2.7 months longer for half the group.
  • A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
  • Put another way, the treated group had about 27 percent lower chance of the event at any given time (hazard ratio 0.73, likely range 0.59 to 0.91).
3-year overall survival ratesurvival endpoint
  • 17.6 vs 5.8 out of 100 alive at 3 years with Durvalumab + EP compared with EP alone; 11.8 more per 100.
  • Roughly one extra person helped for every 8 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
Be careful
  • Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
  • These results apply to the people the trial enrolled: First-line extensive-stage SCLC: platinum-etoposide + durvalumab (± tremelimumab) vs platinum-etoposide. People in a different situation may not see the same effect.

Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.

805 participants enrolled.

Overall survivalprimary
HR 0.73 (0.59–0.91) · p = 0.0047
Durvalumab + EP
13 mo
EP alone
10.3 mo
Source
3-year overall survival rate
Durvalumab + EP17.6 of 100
EP alone5.8 of 100
EndpointArmnValueHR (95% CI)pSource
Overall survivalprimaryDurvalumab + EP26813 months0.73 (0.59–0.91)0.0047link
EP alone26910.3 months
3-year overall survival rateDurvalumab + EP—17.6%———
EP alone—5.8%
Replication
Consistent with IMpower133; the durvalumab-tremelimumab arm's failure was itself replicated by other CTLA-4 add-on attempts in SCLC.

Connected

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Pages like this

not linked directly; found by shared links

cancers

1
Small-cell lung cancer

drugs

3
ApprovedMonoclonal antibody (anti-PD-L1)
Durvalumab · Imfinzi
Not mapped hereCytotoxic regimen
Platinum + etoposide (EP / CE)
ApprovedMonoclonal antibody (anti-CTLA-4)
Tremelimumab · Imjudo