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Target Oncol. 2021 Nov;16(6):857-864. doi: 10.1007/s11523-021-00843-0. Epub 2021 Nov 3.
Durvalumab (IMFINZI), a fully human monoclonal antibody against programmed cell death-ligand 1 (PD-L1), is approved for use in combination with etoposide and either carboplatin or cisplatin for the first-line treatment of patients with extensive-stage small cell lung cancer (ES-SCLC). In the pivotal phase III CASPIAN trial in previously untreated adults with ES-SCLC, the addition of durvalumab to chemotherapy for up to 4 cycles followed by maintenance durvalumab was associated with a significantly longer overall survival and a favourable hazard ratio for progression-free survival compared with chemotherapy alone for up to 6 cycles. A higher proportion of patients in the durvalumab plus chemotherapy group had an objective response compared with the chemotherapy alone group. The efficacy of durvalumab was also sustained with longer follow-up. Durvalumab in combination with etoposide and either carboplatin or cisplatin had a manageable tolerability profile in patients with ES-SCLC. Given the available evidence, durvalumab in combination with etoposide and either carboplatin or cisplatin represents a valuable treatment option for the first-line treatment of patients with ES-SCLC, and is an accepted standard of care option in this setting.
度伐利尤单抗（英飞凡）是一种针对程序性死亡配体 1（PD-L1）的全人源单克隆抗体，已被批准与依托泊苷联合用于广泛期小细胞肺癌（ES-SCLC）患者的一线治疗，联合用药方案包括依托泊苷联合卡铂或顺铂。在未接受过治疗的 ES-SCLC 成人患者中开展的关键性 III 期 CASPIAN 试验中，与单独化疗最多 6 个周期相比，在化疗最多 4 个周期后序贯使用度伐利尤单抗维持治疗可显著延长总生存期（OS），并且无进展生存期（PFS）的风险比（HR）有利。与单独化疗组相比，度伐利尤单抗联合化疗组有更高比例的患者出现客观缓解。随着随访时间的延长，度伐利尤单抗的疗效仍然持续。在 ES-SCLC 患者中，度伐利尤单抗联合依托泊苷联合卡铂或顺铂的治疗方案具有可管理的耐受性。鉴于现有证据，度伐利尤单抗联合依托泊苷联合卡铂或顺铂是 ES-SCLC 患者一线治疗的一个有价值的治疗选择，并且是该治疗环境下可接受的标准治疗选择。
