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Small Cell Lung Cancer: Interpreting Data From IMpower133

Insights From: Charles Rudin, MD, PhD, Memorial Sloan Kettering Cancer Center
Published: Monday, Dec 23, 2019



Transcript: 

Charles Rudin, MD, PhD: The IMpower133 trial was a randomized phase III trial comparing a standard of care of carboplatin and etoposide versus the same chemotherapy regimen with the addition of the anti–PD-L1 [anti–programmed death-ligand 1] inhibitor atezolizumab. It was a 1:1 randomization and included about 400 patients and showed an improvement in median overall survival from about 10½ months in the control arm to about 12½ months on the investigational arm. We would have liked to see a more dramatic change than that, but the median shift was only about 2 months. I think what will be really interesting in looking at this trial going forward is what the long-term outcome is on the investigational arm. We know that some patients treated with immunotherapy do derive long-term benefit with small cell lung cancer. There may be patients who are in fact long-term survivors on that trial. It’s too early to know. We’ve seen only early data from that study to date. We’ll be very eager to see updates in the years going forward.

Currently the uptake of anti–PD-L1 therapy has been primarily in the United States, based on an early approval there. There has been recent adoption of this regimen in Germany as well, and I think this is slowly becoming a change that will happen in the rest of the world as well. For many countries, this is not yet an approved therapy.

Transcript Edited for Clarity

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Transcript: 

Charles Rudin, MD, PhD: The IMpower133 trial was a randomized phase III trial comparing a standard of care of carboplatin and etoposide versus the same chemotherapy regimen with the addition of the anti–PD-L1 [anti–programmed death-ligand 1] inhibitor atezolizumab. It was a 1:1 randomization and included about 400 patients and showed an improvement in median overall survival from about 10½ months in the control arm to about 12½ months on the investigational arm. We would have liked to see a more dramatic change than that, but the median shift was only about 2 months. I think what will be really interesting in looking at this trial going forward is what the long-term outcome is on the investigational arm. We know that some patients treated with immunotherapy do derive long-term benefit with small cell lung cancer. There may be patients who are in fact long-term survivors on that trial. It’s too early to know. We’ve seen only early data from that study to date. We’ll be very eager to see updates in the years going forward.

Currently the uptake of anti–PD-L1 therapy has been primarily in the United States, based on an early approval there. There has been recent adoption of this regimen in Germany as well, and I think this is slowly becoming a change that will happen in the rest of the world as well. For many countries, this is not yet an approved therapy.

Transcript Edited for Clarity
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