Each year, at least 30,000 new cases of small-cell lung cancer (SCLC) are reported in the US, with most patients being diagnosed with aggressive extensive-stage (ES) disease.
ES-SCLC is often challenging to treat and has a poor prognosis. However, recent findings from the phase III IMforte trial have yielded encouraging results for a combination treatment of lurbinectedin and atezolizumab as a first-line maintenance therapy for ES-CLC.
The combination treatment demonstrated statistically significant improvements in overall survival (OS) and progression-free survival (PFS) in patients with ES-CLC compared to treatment with atezolizumab alone. The combination therapy was well tolerated, and the safety data were consistent with the known safety profiles.
The ongoing randomized trial is divided into an induction phase and a maintenance phase. Eligible participants will be randomized in a 1:1 ratio to receive either lurbinectedin in combination with atezolizumab or atezolizumab alone.
Participants need to have an ongoing response or stable disease after completing four cycles of induction treatment with carboplatin, etoposide, and atezolizumab to be eligible for screening for the maintenance phase.
In the maintenance phase, patients are randomized to receive either atezolizumab as a monotherapy or a combination of lurbinectedin and atezolizumab. The dosage and schedule for atezolizumab are the same as those in the induction phase, while lurbinectedin is administered at a dose of 3.2 mg/m2 on the first day of each 21-day cycle during the maintenance phase.1
In the cohort receiving atezolizumab plus lurbinectedin, participants are administered atezolizumab (1,200 mg) on the first day of each 21-day cycle, in combination with carboplatin on day one and etoposide on days one, two, and three of each 21-day cycle, for a total of four cycles during the induction phase.1 In the maintenance phase, patients receive atezolizumab on day one of each 21-day cycle, along with lurbinectedin (3.2 mg/m2) on the first day of each 21-day cycle.1
In the atezolizumab-only cohort, patients in the induction phase receive atezolizumab (1,200 mg) on day one of each 21-day cycle, in combination with carboplatin on day one and etoposide on days one, two, and three of each 21-day cycle for four cycles.1 In the maintenance phase, participants continue to receive atezolizumab (1,200 mg) on day one of each 21-day cycle.1
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