Abstract 679P
Background
Immune check-point inhibitors are accessible to only 1%-3% of eligible patients in low- and middle-income countries due to high cost. Hence, lower doses of immunotherapy are being used in different cancers to improve accessibility, with some success in outcomes. This is the first study evaluating the efficacy of low-dose (LD) Durvalumab in combination with standard etoposide-platinum doublet chemotherapy in first-line treatment of extensive-stage small cell lung cancer (ES-SCLC).
Methods
We retrospectively analyzed 35 patients with ES-SCLC who received Durvalumab 120mg every 3-weekly with standard etoposide-platinum chemotherapy in 1st-line from January 2018 till December 2023 at 3 institutions in Kolkata & Howrah. The primary endpoint was to evaluate efficacy including overall survival (OS), progression-free survival (PFS), and overall response rates (ORR).
Results
The median age of study population was 64 years with 34 males and 1 female. Baseline brain metastasis was present in 34% patients and liver metastasis in 20% patients. 71% were ECOG PS 1 , 28% PS 2 and 1 patient was PS 3 at the time of starting treatment. 75% received carboplatin while 25% received cisplatin. The ORR was 68.6% with 21 patients having PR and 3 patients having CR as the best evaluable response. 71% patients also received consolidation RT to the primary mass. The median no. of LD Durvalumab cycles was 7 (range 3-18). The median PFS in study population was 7.1 months and the median OS was 12.7 months. The median follow-up time was 22 months. 1-year PFS was 14% and OS was 48%. LD Durvalumab was well tolerated with no incidence of Grade III/IV immune-related adverse events.
Conclusions
The results of this study are comparable to the outcomes in the CASPIAN study. LD Durvalumab is an effective option for ES-SCLC patients without access to standard doses and deserves further evaluation in randomized clinical trials to improve access to immunotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.