IMFINZI^® - SoC in ES-SCLC^1,2

Sustained survival benefit³
with CASPIAN as the only^# positive study
with 3-year-OS data vs control³

THE ONLY study with positive 3-year OS data

Summary

IMFINZI^® 1L SoC in ES-SCLC with CASPIAN 3-year OS-data^1-7

Efficacy

3-year OS benefit of 17.6 % vs 5.8 % with IMFINZI^® + EP vs EP alone³
29 % reduction in mortality risk with IMFINZI^® + EP vs EP alone, also after 3 years of follow-up³

Quality of life

Quality of life preserved and longer symptom control in 2 years, including cognitive function⁴

User friendly

Only IO approved in combination with etoposide and carboplatin or cisplatin
Maintenance dosage every 4 weeks⁵
Save valuable time for you and your patients through a once a month administration

Study design

The CASPIAN study design is close to clinical practice^5,6
PCI permitted in the control arm
Patients with untreated asymptomatic or treated symptomatic CNS metastases were included

Status: July 2023

CNS: central nervous system; EP: etoposide + platinum; ES-SCLC: extensive-stage small cell lung cancer; IO: immunotherapy; OS: overall survival; PCI: prophylactic cranial irradiation; SoC: standard of care.

# to date (status: November 2023) and approved in Switzerland

Download CASPIAN flyer

Study design

The CASPIAN study design – close to clinical practice^5,6,§

^§ A comprehensive, randomised, open-label, multi-centre phase III study for IMFINZI^® + EP vs EP alone as first-line treatment in patients with ES-SCLC^5,6

* IMFINZI^® 1500 mg + carboplatin (AUC 5 to 6 mg/mL/min) or cisplatin (75–80 mg m ) on Day 1 and etoposide (80–100 mg/m2) i.v. on Days 1, 2 and 3 of each 21-day cycle for a maximum of 4 cycles, followed by IMFINZI 1500 mg every 4 weeks until disease progression or unacceptable toxicity.^5,6

^† Carboplatin (AUC 5 to 6 mg/mL/min) or cisplatin (75–80 mg/m2) on Day 1 and etoposide (80–100 mg/m2) i.v. on Days 1, 2 and 3 of each 21-day cycle for 4-6 cycles.^5,6

AUC: area under the curve; EP: etoposide + platinum; ES-SCLC: extensive-stage small cell lung cancer; PCI: prophylactic cranial irradiation; Q3W: every 3 weeks; Q4W: every 4 weeks

† 78 % of patients were given carboplatin and 25 % were given cisplatin in both treatment arms.

* Patients with confirmed brain metastases had to receive treatment and be stable for at least 1 month on steroids and anticonvulsants before receiving study treatment.

CNS: central nervous system; PCI: prophylactic cranial irradiation

Results

OS benefit
OS in subgroups
Brain metastases
Without progression

After 3 years - 3× more patients alive with IMFINZI^® + EP vs EP alone

Adapted according to Paz-Ares et al., 2022.³
CI: confidence interval; EP: etoposide + platinum; HR: hazard ratio; OS: overall survival

Safety

Profile of adverse reactions⁶
Immune-mediated profile of adverse reactions^5,7

The incidence of grade 3/4 adverse drug reactions (ADRs) were similar for IMFINZI^® + EP and EP alone (62 %)

Immune-mediated ADRs were observed in 20% of patients on IMFINZI^® + EP and in 3% of patients on EP, with the majority exhibiting grade 1 or 2 ADRs which were generally manageable.

ADR: adverse drug reaction; EP: etoposide + platinum-based chemotherapy (carboplatin or cisplatin)

Treatment and dosing

Simple therapy with just ONE administration per month in the maintenance phase

IMFINZI^® + EP Q3W, followed by only one administration of IMFINZI^® per month⁵

Note: The dosages follow the protocol for the CASPIAN study.
Please also note the relevant Information for Healthcare Professionals.⁵

IMFINZI^® is SL-listed and therefore the utilisation does not require an additional “Kostengutsprache” (engl. Confirmation of coverage).
More information can be found on the website www.spezialitaetenliste.ch

# Administer IMFINZ^® on the same day before chemotherapy. Please also refer to the Information for Healthcare Professionals for etoposide and carboplatin or cisplatin for information on the dosage.⁵

§ The dosage must be adjusted to body weight in patients weighing 30 kg or less, equivalent to 20 mg/kg IMFINZI^® in combination with chemotherapy every 3 weeks (21 days) for 4 cycles, followed by 20 mg/kg every 4 weeks as a monotherapy until body weight increases to above 30 kg.⁵

EP: etoposide + platinum; Q3W: every 3 weeks.

◊ List of specialities. www.spezialitaetenliste.ch.

Real-World Evidence

Durvalumab confirmed as standard in ES-SCLC

The phase III CASPIAN trial has made durvalumab a standard of care for first-line treatment of advanced small cell lung cancer (SCLC) (extensive disease; ES-SCLC). Over 3 years, durvalumab plus cis- or carboplatin and etoposide (EP) reduced the risk of death by 29% compared to EP alone.³ The Spanish phase IIIb study CANTABRICO now confirms the efficacy and safety of durvalumab plus EP under real-world conditions.⁹

The results of the phase IIIb CANTABRICO study demonstrate that ES-SCLC therapy with durvalumab plus EP is effective and safe in a broad group of patients, even under real-world conditions.⁹ Both the PFS and the safety profile were similar to the phase III CASPIAN study. The 6-month PFS was even 5% higher in the overall CANTABRICO population than in CASPIAN.^7,9 These results confirm the standard of care of durvalumab plus EP for first-line ES-SCLC patients.⁹ In addition to the data shown, the CANTABRICO study is also investigating immunological and biological characteristics of ES-SCLC patients before therapy, between induction and maintenance therapy, and at the time of progression. These biomarker analyses may provide future insights into the molecular genetic disease process of ES-SCLC.⁹

Download our article about the CANTABRICO study (DE)

Guidelines

IMFINZI^® in ES-SCLC is recommended by ESMO Guidelines²

In the ES-SCLC, therapy with durvalumab in combination with platinum and etoposide should be offered to all eligible patients with ECOG status 0-1 who have not received prior chemotherapy.²

Download ESMO guidelines flyer

References

NCCN Guidelines SCLC, online available: https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf (last access: 12.10.2023).
ESMO Guidelines SCLC, online available: https://www.esmo.org/guidelines/guidelines-by-topic/esmo-clinical-practice-guidelines-lung-and-chest-tumours/small-cell-lung-cancer (last access: 02.02.2024).
Paz-Ares L, et al. Durvalumab, with or without tremelimumab, plus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer: 3-year overall survival update from CASPIAN. ESMO Open. 2022; 7 (2): 100408.
Goldman JW, et al. Patient-reported outcomes with firstline durvalumab plus platinum-etoposide versus platinum-etoposide in extensive-stage small-cell lung cancer (CASPIAN): a randomized, controlled, open-label, phase III study. Lung Cancer. 2020 Nov; 149: 46–52.
IMFINZI^® Information for Healthcare Professionals. www.swissmedicinfo.ch.
Paz-Ares L, et al. Durvalumab plus platinum-etoposide versus platinum-etoposide in firstline treatment of extensive-stage small-cell lung cancer (CASPIAN): a randomized, controlled, open-label, phase 3 trial. Lancet. 2019; 394(10212): 1929–1939.
Goldman JW, et al. Durvalumab, with or without tremelimumab, plus platinum–etoposide versus platinum–etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): updated results from a randomised, controlled, open-label, phase 3 trial. Lancet Oncol. 2021; 22(1): 51–65.
Chen Y, et al. Impact of Brain Metastases on Treatment Patterns and Outcomes With First-Line Durvalumab Plus Platinum-Etoposide in Extensive-Stage SCLC (CASPIAN): A Brief Report. JTO Clin Res Rep 2022; 3(6): 100330.
Isla D, et al. Phase IIIb study of durvalumab plus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CANTABRICO): preliminary efficacy results. Ann Oncol. 2022; 33(S7):S1247-S1248.

Professionals can request the mentioned references from AstraZeneca AG.

IMFINZI® - SoC in ES-SCLC1,2

IMFINZI® 1L SoC in ES-SCLC with CASPIAN 3-year OS-data1-7

The CASPIAN study design – close to clinical practice5,6,§

After 3 years - 3× more patients alive with IMFINZI® + EP vs EP alone