CASPIAN: Long-Term Follow-up Data and Potential Predictors for Treatment Outcomes

EP: 1.Importance of Early Referral and Diagnosis in Small-Cell Lung Cancer

EP: 2.Impact of Disease Staging on Prognosis and Treatment in SCLC

EP: 3.Evolving Role of Biomarkers in SCLC

EP: 4.Patient Scenario 1: Newly Diagnosed ES-SCLC With Presence of Hepatic and Brain Metastases

EP: 5.Expert Insights on First-line Treatment Strategies in SCLC

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EP: 6.CASPIAN: Long-Term Follow-up Data and Potential Predictors for Treatment Outcomes

EP: 7.Combination Therapy Approaches With Chemotherapy and Immunotherapy in ES-SCLC

EP: 8.ADRIATIC Trial and Investigational Treatment Approaches for Limited-Stage SCLC

EP: 9.Patient Scenario 2: 1L Management of ES-SCLC Positive for Synaptophysin With a Ki-67 Score of 90%

EP: 10.Real World Data for Combination Strategies With Chemotherapy and Immunotherapy in ES-SCLC

EP: 11.Patient Scenario 3: 2L Lurbinectedin Following 1L Combination IO Chemotherapy

EP: 12.Evolving Treatment Strategies for SCLC in the Second-Line Setting and Beyond

EP: 13.LAGOON and IMFORTE Trials: Data Updates and Expert Insights

EP: 14.2L Dosing Considerations and Management Strategies for SCLC

EP: 15.Novel Treatment Approaches for SCLC and Future Perspectives

Transcript:

Taofeek K. Owonikoko, MD, PhD: Dr Chiang, we’ve heard about the tail of the curve with the addition of immunotherapy to chemotherapy. Can you share some of the recent updates in terms of long-term outcomes for some of the trials that we’ve now recognized as pivotal trials specifically? We had 3-year overall survival [OS] data from the CASPIAN trial. We’ve not had similar readouts from the IMpower trial, but we did have the 24 [month] readout from the IMpower133 trial. What do you think we should take away from this…in the long-term overall follow-up from these studies?

Anne Chiang, MD, PhD: I love showing my patients the tail of the curve for the CASPIAN trial. I have a copy I show to them because it’s really important that they know they could [still be alive] in 3 years. Even if they have disease that spread to the brain, there’s an outlook there, obviously; we’d love for that to be more of the population. But the fact is we’re looking at 3 years, the fact is that the CASPIAN trial showed us that you can triple the survival there from 6% to 18%. And we’re working on clinical trials to try to improve that even more. I think that’s just such an important message to give them.

Taofeek K. Owonikoko, MD, PhD: And with this, do you have any clinical or perhaps some sort of biomarker that could help predict who is going to be in that tail of the curve? When you talk to the patient, are you able to assure them that based on this or that, that they are likely to be in that tail rather than that initial cliff that a lot of our patients unfortunately experience?

Anne Chiang, MD, PhD: I wish I had that crystal ball; I don’t have that power. But I think that we can tell them that we’re really working on it. There are data, the more and more tissue that we get, we can start to look at our long-term responders, our long-term survivors, and look to see what characteristics they have. And some things that we have looked at are, for example, if they have… well, first of all, the patients who do well, are the ones who continue to do well. And we already had that concept of platinum sensitivity before, where if your disease after you finish your chemotherapy, it’s more than 6 months before you have recurrent disease, then your outlook is better than if you recurred in 3 months. So [we can tell] those patients [it’s great] if you have a better response to begin with, if that response lasts for a longer period of time. Those are the characteristics that in some studies have characterized long- term survivors, patients who have liver mets [metastases]; one study showed a worse prognosis than patients who didn’t. Then again, we’re starting to look at some of those markers like PD-L1, [which includes] very few patients…. In one study, CheckMate 032, there were probably 10% of patients who were positive for PD-L1 in some way. In the KEYNOTE trial, it was somewhere, if you change the definition to include the immune cells, then you could get up to around 30%. [In] at least one study if [there was] some PD-L1 expression, that may be correlated with those patients who are long-term survivors, [those who] seem to have a little more PD-L1 expression, but we’re still learning about that.

Transcript edited for clarity.