Osimertinib plus local therapy improves outcomes in EGFR-mutant metastatic lung cancer
15 Apr 2026
The ADRIATIC trial was a trial conducted with patients in limited-stage small cell lung cancer. The results have been presented before. The patients were included after completing definitive radiochemotherapy and it was a three-arm trial. Patients were given either placebo, or durvalumab 1500mg every four weeks for 24 months, or durvalumab and tremelimumab as a combination therapy. The last arm is still blinded, the results have not been released yet but the ADRIATIC trial showed superior PFS and OS for patients treated with consolidation durvalumab therapy after radiochemotherapy for limited-stage small cell lung cancer. The poster I presented at the ELCC in Copenhagen this year was about subsequent therapy and the PFS2, so the progression free survival after the first subsequent therapy.
Could you elaborate on the study design?
Like I said, the patients were included after finishing the definitive chemoradiotherapy. It was supposed to be simultaneous and not sequential. Patients had to have had three cycles at least of cisplatin or carboplatin combined with etoposide. They could have had PCI, prophylactic cranial irradiation, it was a maybe. Patients were included in the trial after the completion of the PCI if done. An important discriminating factor to the PACIFIC trial in the NSCLC setting was that the consolidation treatment was given for 24 months, whereas in the PACIFIC trial for NSCLC it was given for 12 months.
What were the key findings?
The durvalumab treatment as a consolidation after chemoradiotherapy significantly prolonged the progression free survival and the overall survival for these patients.
What could be the clinical significance of these results?
There is a large medical need to improve treatment for small cell lung cancer patients because it’s a very aggressive disease. Patients do relapse often and they often relapse with distant metastasis and if done so the prognosis is extremely poor. So this is a very valuable trial to help the patients to not relapse and essentially cure them in the end.
It’s an “easy” treatment, it’s feasible, we’ve done this for ten years now, almost ten years, in the PACIFIC regimen in NSCLC patients so we can we handle the substance, we know how to do this. So it’s very essential that also for the SCLC patients we do have something in the basically curative stage where we know that actually the prognosis is still poor. So this is helpful.
