AstraZeneca's durvalumab (Imfinzi) has received a positive recommendation from the Committee for Medicinal Products for Human Use (CHMP) for treating adult patients with limited-stage small cell lung cancer (LS-SCLC) following successful chemoradiation therapy (CRT). This milestone brings a potential new treatment option closer to European patients with this aggressive form of lung cancer.
Landmark Phase 3 Trial Results
The recommendation is supported by compelling data from the phase 3 ADRIATIC trial (NCT03703297), which demonstrated significant survival benefits. Patients receiving durvalumab showed a median overall survival of 55.9 months compared to 33.4 months with placebo, representing a 27% reduction in death risk (HR, 0.73; 95% CI, 0.57-0.93; P = 0.0104).
Progression-free survival (PFS) also showed marked improvement, with durvalumab patients achieving a median of 16.6 months versus 9.2 months for placebo (HR, 0.76; 95% CI, 0.61-0.95; P = 0.0161).
Subgroup Analysis Shows Broad Benefits
The trial revealed particularly strong benefits in specific patient populations:
- Patients treated within 14 days of concurrent CRT
- Those with stable disease
- Individuals with WHO performance status of 0
"ADRIATIC was the first phase 3 trial in decades to demonstrate a survival benefit in limited-stage SCLC," noted Professor Suresh Senan, PhD, from Amsterdam University Medical Centers, the study's principal investigator. "Today's positive recommendation from the CHMP means that our patients in Europe are one step closer to gaining access to this practice-changing treatment regimen."
Trial Design and Patient Demographics
The ADRIATIC trial enrolled 730 patients, with 264 receiving durvalumab monotherapy and 266 receiving placebo. The study population was well-balanced, with a median age of 62 years across both arms. Most patients were male (approximately 70%) and either White or Asian, with over 90% being current or former smokers.
Safety Profile
The safety analysis revealed manageable adverse events:
- Any-grade adverse events: 94.3% in durvalumab arm vs 88.3% in placebo
- Grade 3 or higher adverse events: 24.4% vs 24.2%
- Serious adverse events: 29.8% vs 24.2%
Treatment discontinuation rates due to adverse events were 16.4% for durvalumab and 10.6% for placebo.
This European recommendation follows the FDA's approval of durvalumab for LS-SCLC patients in December 2024, establishing a growing global recognition of this treatment's value in addressing an important unmet medical need.
