Immunotherapy drug imfinzi can significantly improve survival benefit and long-term efficacy in patients with extensive small cell lung cancer

Today, AstraZeneca released detailed clinical data of Caspian, a phase III clinical trial Imfinzi (durvalumab) can significantly improve the overall survival of patients with extensive small cell lung cancer without systematic treatment Compared with the standard treatment of small cell lung cancer, i.e up to six cycles of chemotherapy and selective prophylactic brain radiotherapy, durvalumab combined with four cycles of standard chemotherapy (etoposide combined with cisplatin or carboplatin) can significantly improve the overall survival period, with statistical and clinical significance The median overall survival (OS) was 13.0 months in the durvalumab group and 10.3 months in the standard group, with a 27% reduction in the risk of death (HR = 0.73) The 18 month survival rate was 33.9% in the durvalumab group and 24.7% in the standard group Among all the therapeutic indexes, durvalumab combined chemotherapy showed benefits compared with standard treatment The results showed that the 12-month progression free survival rate (17.5% vs 4.7%) and the objective remission rate (67.9% vs 57.6%) of durvalumab combined chemotherapy had significant advantages, and the longer remission duration (22.7% vs 6.3% at 12 months) The above clinical data were released at the plenary session of the 2019 world lung cancer conference, which was held in Barcelona, Spain and hosted by the International Association for lung cancer research (IASLC) Jose baselga, global executive vice president of AstraZeneca and head of research and development in cancer treatment, said: "we are very pleased to see that after durvalumab combined chemotherapy, more than one third of patients with small cell lung cancer are still alive 18 months later, which is a great data for extremely malignant small cell lung cancer It is worth noting that these data provide a basis for physicians to choose durvalumab combined with cisplatin or carboplatin chemotherapy to treat patients with small cell lung cancer We look forward to working with regulators to bring durvalumab to small cell lung cancer patients worldwide as soon as possible " Professor Luis Paz Ares, director of Oncology Department of docedeoctubre University Hospital in Madrid, Spain, who is the main researcher of Caspian clinical trial, said: the treatment options of small cell lung cancer patients are very limited, and the 5-year survival rate is only about 6%; Caspian clinical trial proved that durvalumab combined with 4-cycle chemotherapy has better effect than traditional chemotherapy, which can significantly improve the survival period of patients, which is good for small cell lung cancer It is a new choice and hope for patients Small cell lung cancer (SCLC) is a rapidly growing cancer Although it is sensitive to chemotherapy with platinum, it will recur and progress rapidly The data of total survival, progression free survival and objective remission rate of cisplatin or carboplatin I I selected by etoposide + researchers were statistically analyzed as of March 11, 2019 III progression free survival was not statistically analyzed I the objective remission rate confirmed was evaluated by researchers, and the standard was recistv1.1 The safety and tolerance of durvalumab combined with etoposide and platinum containing chemotherapy were consistent with the previous results The clinical data showed that 61.5% and 62.4% of patients in durvalumab group and standard treatment group had grade 3-4 adverse events respectively, and the proportion of patients in two groups who stopped treatment due to adverse events was similar (9.4% vs 9.4%) For local small cell lung cancer, phase III clinical trial Adriatic is evaluating the efficacy of durvalumab after concurrent radiotherapy and chemotherapy Based on the results of phase III Pacific test, durvalumab has been approved in 49 countries including the United States, Japan and the European Union for the consolidation treatment of stage III unresectable non-small cell lung cancer after radiotherapy and chemotherapy for the purpose of cure >>>>The Caspian CASPIAN study is a randomized, open label, global, multicenter, phase III clinical trial for the first-line treatment of patients with extensive small cell lung cancer This clinical trial was divided into three groups: durvalumab combined with standard chemotherapy (etoposide + cisplatin or carboplatin), durvalumab + tremelimumab (anti-CTLA-4 antibody) + chemotherapy group and control group In the experimental group, patients received up to four cycles of chemotherapy In the control group, patients received up to 6 cycles of chemotherapy, and preventive brain radiotherapy was selected according to the situation This clinical trial will continue until the survival data of durvalumab + tremelimumab + chemotherapy combined group is mature The clinical trial was conducted in more than 200 centers in 22 countries around the world, including the United States, Europe, South America, Asia and the Middle East The primary end point of this clinical trial was total survival >>>>Small cell lung cancer has become the main cause of cancer death in men and women, accounting for about one fifth of all cancer deaths Generally, lung cancer is divided into non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) The proportion of small cell lung cancer (SCLC) is about 15% About 3 / 4 of the patients with small cell lung cancer are in extensive stage when they are diagnosed The cancer cells have spread or transferred to other tissues or organs in the lung The prognosis of small cell lung cancer is very poor, the 5-year survival rate is only about 6% >>>>Durvalumab durvalumab is a human monoclonal antibody of PD-L1, which can block the binding of PD-L1 with PD-1 and CD80, thus blocking tumor immune escape and releasing the inhibited immune response Durvalumab has been approved for the treatment of advanced bladder cancer in 10 countries including the United States As a part of the new drug research and development project, durvalumab is currently in the form of drug alone or in combination with CTLA-4 antibody tremelimumab and other new drugs to explore the treatment prospects in the fields of non-small cell lung cancer, small cell lung cancer, bladder cancer, head and neck cancer, liver cancer, cervical cancer, bile duct cancer and other solid tumors >>>>AstraZeneca research in the field of lung cancer AstraZeneca has a number of drugs that have been approved or are in the late stage of clinical research and development, which are suitable for lung cancer diseases with different stages, different treatment stages and different mechanisms of action We have met the unmet treatment needs of EGFR mutation positive non-small cell lung cancer patients through the listed eresa, Teresa, ongoing phase III clinical trials (adaura, Laura, flaura and flaura2) and exploratory combination phase II clinical trials (Savannah and orchard), about 10% - 15% of European and American non-small cell lung cancer patients and about 30% - 40% of Asian non-small cell lung cancer patients Lung cancer patients will benefit At the same time, the cancer immunotherapy project that AstraZeneca is widely carrying out is also in the late stage of clinical research and development, targeting about three quarters of all lung cancer patients without known gene mutations Durvalumab, an anti-PD-L1 antibody, is currently conducting research on advanced lung cancer patients (including phase III clinical trials Poseidon, pearl and Caspian) and early stage lung cancer patients (including phase III clinical trials aegene, pacific-2, Adriatic, adjuvantbr.31, pacific-4 and pacific-5), both of which are single drug or combined with tremelimumab and / or chemotherapy >>>>Research strategy of AstraZeneca on tumor immunotherapy tumor immunotherapy is a treatment strategy to attack tumor by activating the immune system of patients Our combination of immunotherapy drugs is designed to overcome tumor inhibition of the immune system For most cancer patients, we believe that immunotherapy will provide them with unprecedented treatment opportunities For different types, stages and treatment history of cancer patients, we are exploring the use of durvalumab single drug or durvalumab combined with CTLA-4 antibody tremelimumab, and the expression of PD-L1 as a predictor to provide the best treatment strategy for different patients In addition, our immunotherapy drugs combined with radiotherapy, chemotherapy, and small molecule targeted drugs from our company and partners will have the potential to provide new treatment strategies for a wider range of cancer patients >>>>Cancer research of AstraZeneca AstraZeneca has a long history in the field of cancer research Our rapidly growing portfolio of new drugs will change the lives of patients and bring infinite possibilities for the future development of the company With the launch of at least six new drugs between 2014 and 2020, as well as a R & D pipeline enriched by small molecules and biological preparations under research, we will be committed to promoting the new tumor business to become one of the six business development platforms of AstraZeneca, and will focus on the research of tumors in the four disease areas of lung, ovary, breast and blood In addition to our core competencies, we actively seek innovative partnerships and external investment to accelerate our strategy, such as our investment in acerta pharmaceutical for blood disease research By using four scientific platforms of tumor immunotherapy, tumor driving gene and drug resistance mechanism, DNA damage repair and antibody coupled drugs, and advocating the development of personalized combination, AstraZeneca aims to redefine cancer treatment and conquer cancer in the future >>>>As for AstraZeneca, AstraZeneca is a global biopharmaceutical enterprise with scientific supremacy, focusing on R & D, production and marketing of prescription drugs, focusing on three major disease areas: tumor, cardiovascular, kidney, metabolism and respiration AstraZeneca operates in more than 100 countries, and innovative drugs benefit millions of patients around the world Statement: at present, durvalumab products are still in the research and development stage, and have not been approved in China The relevant information provided in this material shall not be used as treatment or use suggestions, nor for promotion purposes under any circumstances Kalemkeriangp, et al Treatment options for relapsedsmall cell lung cancer: whatprogresshavewemade? 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