Joshua K. Sabari, MD, discusses his use of durvalumab in the frontline setting for the treatment of patients with small-cell lung cancer and where he sees the role for the treatment.
Joshua K. Sabari, MD, medical director of Kimmel Pavilion 12 at NYU Langone Health’s Perlmutter Cancer Center and assistant professor of medicine at NYU Grossman School of Medicine, explains his thoughts on the use of durvalumab (Imfinzi) for patients with extensive-stage small cell lung cancer (ES-SCLC).
Results from the phase 3 CASPIAN trial (NCT03043872) were positive for patients with ES-SCLC when durvalumab was given in combination with tremelimumab (Imjudo) and given in conjunction with carboplatin or cisplatin and etoposide as it improved their overall survival. Moreover, there was an objective response rate (ORR) of 68% in patients in the CASPIAN trial compared with the addition of atezolizumab in the Impower133 trial (NCT02763579) with an ORR of 60%.
According to Sabari, when to use durvalumab in the frontline setting is ultimately up to the physician and the needs of the patient. He discusses that while trials have shown durvalumab’s positive results, there are still considerations depending on the individual situation. However, he does see that durvalumab is interchangeable in this setting.
0:08 | It is interesting. I think the use of durvalumab in the frontline setting is dependent on your practice preference. If you are using cisplatin in your frontline setting, which I often do not and often most practitioners the United States do not, but if you are in Europe and you're using cisplatin, I think using durvalumab regimen [in the frontline] makes more sense.
0:27 | If you're a practitioner that does the 6 cycles of therapy in the frontline setting, I think using durvalumab makes more sense [as well]. In my current practice, I am generally using 4 cycles of carboplatin and etoposide. Therefore, both regimens with durvalumab or atezolizumab are interchangeable in my experience.