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  1. Alice Davies
  1. Lungs for Living Research Centre UCL Respiratory, University College London, London, WC1E 6JF, UK
  1. Correspondence to Dr Alice Davies, Lungs for Living Research Centre, UCL Respiratory, University College London, London WC1E 6JF, UK; alice.davies{at}

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Addition of durvalumab to first-line chemotherapy in small cell lung cancer

Prognosis and treatment options for small cell lung cancer (SCLC) remain poor and it is yet to see the benefits in prognosis conferred by immunotherapy in non-SCLC. CASPIAN was a randomised, open-label, phase III trial assessing the efficacy and safety of durvalumab (a monoclonal antibody that blocks PD-L1), with or without tremelimumab (a monoclonal antibody against CTLA-4) in combination with chemotherapy with platinum–etoposide, for the first-line treatment of patients with extensive stage SCLC (ES-SCLC). A total of 805 treatment-naive patients across 20 sites were randomly assigned into each cohort 1:1:1. Paz-Ares et al (Lancet 2019:doi10.1016/S0140-6736(19)32222-6) report the interim survival analysis of the durvalumab plus platinum–etoposide versus platinum–etoposide groups. The addition of durvalumab was associated with a significant improvement versus chemotherapy alone in clinical outcomes including overall survival, with a HR of 0.73 (95% CI 0.59 to 0.91; p=0·0047); median overall survival was also prolonged at 13.0 (95% CI 11.5 to 14.8) months versus 10.3 (95% CI 9.3 to 11.2) months. Similar adverse events profiles were reported in both groups. These results align with those reported …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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