LUMINANCE: Results support use of durvalumab and platinum-etoposide for extensive stage SCLC

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Published: 6 Apr 2023
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Dr Niels Reinmuth - University of Muenster, Gauting, Germany

Dr Niels Reinmuth speaks to ecancer about the preliminary results from LUMINANCE, a phase 3b, single-arm study of first line durvalumab (D) and platinum-etoposide (EP) for patients with extensive-stage small cell lung cancer (SCLC).

He explains the preliminary results, which they presented at ELCC 2023, showed no new signals regarding toxicity in this context.

Preliminary safety and efficacy findings from LUMINANCE were consistent with those observed in CASPIAN. The most common grade >3 adverse events were those typically associated with chemotherapy.

Dr Reinmuth says that the results further support the use of D+EP as first line tx for patients with ES-SCLC.

Dr Reinmuth concludes by looking toward the future steps for this study.

The LUMINANCE study takes on from the CASPIAN study where chemotherapy in small cell lung cancer led to improvement in overall survival when combined with durvalumab versus chemotherapy alone. However, in that study only ECOG performance status 0 and 1 were allowed, there was no PCI in the combination chemotherapy plus durvalumab. Therefore, the LUMINANCE study was a study programme set up in particular to collect information on patients with ECOG performance 2, to look whether the results of CASPIAN can be reproduced and also to look for the possibility of PCI.

The study is ongoing, there were interim results which have been presented demonstrating a similar efficacy as compared to the CASPIAN study and also no new toxicity, therefore confirming the CASPIAN results.

The vast majority of patients who have been included in LUMINANCE so far, as I said the study is ongoing, were from ECOG performance 0 and 1. There were no new signals regarding toxicity in this context. Also, it looks like the majority had no PCI but PCI per se was doable and can be done in this context. But there were no new safety signals and the efficacy was similar as shown already in the phase III study.

How might these results impact the future treatment of SCLC?

The study is ongoing therefore it is difficult to draw final conclusions so far but it looks like combination chemotherapy with durvalumab can be reproduced in another study here. It is first choice treatment for small cell lung cancer with extensive disease stage. Finally, it also gives us more information on a broader patient population which may benefit from this kind of population and also that includes the possibility of applying PCI.