Outcomes of real-world CANTABRICO trial match results from CASPIAN

Reflecting a broader patient population and treatment practices in Spain, the real-world CANTABRICO trial demonstrated a similar safety profile and clinical benefit of durvalumab/EP as those from the phase 3, randomised CASPIAN trial.

Small cell lung cancer (SCLC) represents approximately 13% of all newly diagnosed lung cancers. Most patients with SCLC have extensive-stage disease (ES-SCLC) at presentation, and prognosis remains poor [1]. Recently, the phase 3 CASPIAN trial (NCT03043872) demonstrated an improved overall survival (OS) with durvalumab plus platinum-etoposide (EP) versus EP alone in treatment-naïve patients with ES-SCLC [2,3]. However, there is limited information on the efficacy and safety of this regime in, for example, patients with ECOG performance status 2, specific comorbidities, controlled autoimmune diseases, or patients where the physician can expect a benefit from prophylactic cranial irradiation. The real-world CANTABRICO trial (NCT04712903) aims to address these questions. Dr Dolores Isla (Hospital Clinico Universitario Lozano Blesa, Spain) presented the first results [4].

A total of 101 patients with treatment-naïve ES-SCLC, including progressive disease after at least 6 months without treatment for LS-SCLC, were enrolled and treated similarly as in CASPIAN (4–6 cycles durvalumab/EP followed by durvalumab maintenance). Baseline demographic characteristics of the CANTABRICO population (n=101) were comparable with the CASPIAN population (n=265).

Overall, the efficacy of durvalumab in CANTABRICO was consistent with that observed in CASPIAN. While there were less partial responses in CANTABRICO than in CASPIAN, disease control rate (CR+PR+SD) was similar in both cohorts (85% vs 75%; see Table).

Table: Response rates in CANTABRICO and CASPIAN [4]



In CANTABRICO, 40% of patients received ≥5 cycles EP (limited to 4 cycles in CASPIAN). The increased number of cycles did not have a detrimental effect on safety. The most common adverse event leading to treatment modification was haematological toxicity, due to EP. Durvalumab was discontinued by 5 patients due to nephritis, liver toxicity, rash, or skin reaction.

Dr Isla concluded that in this broader patient population at treatment practices in Spain, the safety profile and clinical benefit of durvalumab were consistent with results from CASPIAN.

1. Wang S, et al. Sci Rep 2017;7:1339.


2. Paz-Ares L, et al. 2019;394:1929–1939.


3. Goldman JW, et al. Lancet Oncol. 2021;22:51–65.


4. Isla D, et al. Phase IIIb study of durvalumab plus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CANTABRICO): Treatment patterns of chemotherapy combination phase with durvalumab. Abstract 142P. ELCC 2022 Virtual Meeting, 30 March–02 April.

 

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Posted on 25 May, 2022