AstraZeneca’s Imfinzi shows positive results in phase 3 trial for treatment of limited-stage small cell lung cancer

1. Imfinzi reduced risk of death by 27% and reduced disease progression by 24% compared to patients receiving a placebo.
2. In both the placebo group and treatment group, adverse events occurred in 24% of patients.

The Latest

The ADRIATIC trial, a multicenter, randomized, double-blind phase 3 study, investigated the effects of AstraZeneca’s PD-L1 inhibitor Imfinzi (durvalumab) in patients with limited-stage small cell lung cancer and prior chemotherapy treatment. Results from the ADRIATIC trial demonstrate that Imfinzi met its primary outcomes of prolonging progression-free survival and overall survival compared to placebo-controlled patients. 46% of patients receiving Imfinzi had no disease progression after two years, compared to only 34% of patients in the placebo group. Patients receiving Imfinzi had estimated survival of 55.9 months compared to 33.4 months for placebo patients. The occurrence of adverse events was similar between patients receiving Imfinzi (24.4%) and placebo (24.2%). 16.4% of patients discontinued treatment due to adverse effects. Death was reported in 2.7% of patients compared to 1.9% in the placebo group.

Physician’s Perspective

Lung cancer is the leading cause of cancer mortality worldwide. It is classified into two histological categories: non-small cell lung cancer or small cell lung cancer. Small cell lung cancer is further divided into limited or extensive stages, which indicate the extent to which the cancer has spread in the lungs, lymph nodes, and rest of the body. Limited-stage small cell lung cancer is an aggressive cancer with a survival rate between 15% and 30%.  Despite existing treatments, such as chemotherapy and radiation, small cell lung cancer has high relapse and mortality rates. Novel immunotherapies, like Imfinzi, are targeted to attack specific proteins found in the cancer cells. By inhibiting proteins that give cancer cells survival advantages, these drugs improve the immune system’s ability to attack the cancer cells and therefore slow tumor progression.

Molecular Targets

Imfinzi is an IgG1 monoclonal antibody, an immune system protein that is programmed to bind the PD-L1 protein found in lung cancer cells. Once bound, it prevents PD-L1 from interacting with other proteins that enable the cancer cells to evade the immune system. Inhibiting these functions allows the body’s immune cells, known as T cells, to kill the cancer cells. Imfinzi is classified as an immune checkpoint inhibitor because it blocks PD-L1, the checkpoint protein, from avoiding immune attack.

Company History

Imfinzi was developed by AstraZeneca, a multinational pharmaceutical and biotechnology company. AstraZeneca has manufactured other lung cancer immunotherapies, including Imjudo (tremelimumab), a monoclonal antibody against CTLA-4. Imjudo is already approved in combination with Imfinzi for certain lung and liver cancers, with ongoing trials investigating their use in other cancer subtypes. AstraZeneca researches, develops, and manufactures drugs for many diseases, including other cancers, rare disorders, and vaccines for influenza and COVID-19.

Further reading: https://www.nejm.org/doi/full/10.1056/NEJMoa2404873

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