Durvalumab Plus Platinum-Etoposide in Extensive-Stage Small-Cell Lung Cancer: Outcomes in Age, Sex, and Platinum Subgroups From the Phase 3 CASPIAN Study.

Authors

Niels Reinmuth, Jonathan W Goldman, Yuanbin Chen, Katsuyuki Hotta, Dmytro Trukhin, Galina Statsenko, Maximilian Hochmair, Mustafa Özgüroğlu, Jun Ho Ji, Marina Chiara Garassino, Artem Poltoratskiy, Francesco Verderame, Libor Havel, Igor Bondarenko, György Losonczy, Nikolay Conev, Shannon Kummer, Helen Mann, Priti Chugh, Tapashi Dalvi, Luis Paz-Ares

Published in

Clinical lung cancer. Aug 06, 2025. Epub Aug 06, 2025.

Abstract

In the phase 3 CASPIAN study, first-line durvalumab plus etoposide combined with either carboplatin or cisplatin (EP) significantly improved overall survival (OS) versus EP alone in treatment-naïve extensive-stage small-cell lung cancer (ES-SCLC). We report exploratory subgroup analyses from CASPIAN.
Patients with untreated ES-SCLC were randomized to durvalumab plus EP or EP alone. We analyzed OS and safety in subgroups defined by age, sex, and planned platinum agent, and patient-reported outcomes (PROs) by age.
Of 537 patients (durvalumab plus EP: n = 268; EP alone: n = 269), 80.6% versus 19.4% were aged <70 versus ≥70 years; 69.6% versus 30.4% were male versus female; and planned platinum was cisplatin versus carboplatin in 25.1% versus 74.9%. The OS HRs for durvalumab plus EP versus EP were 0.71 (95% CI, 0.58-0.88) versus 0.74 (95% CI, 0.49-1.11) for patients aged <70 versus ≥70 years; 0.76 (95% CI, 0.62-0.95) versus 0.60 (95% CI, 0.42-0.84) for males versus females; and 0.65 (95% CI, 0.45-0.94) versus 0.74 (95% CI, 0.60-0.91) for planned cisplatin versus carboplatin. With durvalumab plus EP, rates of grade 3/4 adverse events (AEs) were similar across subgroups; serious AEs were more frequent in patients aged ≥70 versus <70 years; and immune-mediated AEs were more common in females versus males. Adding durvalumab to EP had no detrimental effect on PROs in either age subgroup.
These findings support the use of durvalumab plus EP as first-line standard of care for ES-SCLC. Additional trials focused on elderly populations would be informative.

PMID:
40887341
Bibliographic data and abstract were imported from PubMed on 01 Sep 2025.

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