Exciting news in the field of oncology as Dr. Julie Gralow, ASCO’s chief medical officer, presents the interim results of the ADRIATIC trial at the 2024 Plenary Session. The trial focuses on assessing durvalumab as a consolidation treatment for patients with limited-stage small cell lung cancer.
The ADRIATIC trial is a significant study in limited-stage small cell lung cancer, aiming to evaluate the effectiveness of durvalumab as a consolidation treatment. Currently, the standard of care for this type of cancer involves concurrent platinum-based chemotherapy with radiation, often accompanied by prophylactic cranial radiation.
The trial design is complex, with three arms. Patients receive the standard of care, which includes platinum-based chemo radiation and prophylactic cranial radiation. The experimental arms consist of durvalumab plus placebo, durvalumab with tremelimumab, and placebo plus placebo for consolidation after the initial treatment. The immunotherapy is administered every 4 weeks for 4 cycles, followed by durvalumab or placebo for up to 2 years.
The study has dual endpoints of overall survival and progression-free survival, with the comparison between durvalumab and placebo. The results from 730 patients in the study show a significant difference in overall survival and progression-free survival. The median overall survival for durvalumab was 55.9 months compared to 33.4 months for placebo, with a hazard ratio of 0.73. Progression-free survival was also notably improved with durvalumab, showing a median of 16.6 months versus 9.2 months for placebo.
Interestingly, the study found that grade 3-4 adverse events were similar between the durvalumab and placebo arms, with a slightly higher rate of treatment discontinuation due to adverse events in the durvalumab group. Pneumonitis was a common side effect observed in the durvalumab consolidation arm.
In conclusion, the ADRIATIC trial represents a significant advancement in the treatment of limited-stage small cell lung cancer, potentially changing clinical practice in this field. The positive outcomes observed in terms of overall survival and progression-free survival indicate the potential benefits of durvalumab as a consolidation treatment for these patients.
