Brief Report: Patterns of Disease Progression with Durvalumab versus Placebo After Concurrent Chemoradiotherapy for Limited-Stage SCLC in the Phase 3 ADRIATIC Trial
In brief
Durvalumab lowers extrathoracic progression from 30% to 20% after chemoradiation
In a post-hoc analysis of patients with limited-stage small-cell lung cancer who had no progression after chemoradiation, extrathoracic lesions occurred in 20% with durvalumab versus 30% with placebo; brain lesions occurred in 7% versus 12%. Time to progression or death also favored durvalumab, though the exploratory findings do not establish which patients benefit most.
- Journal
- Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer (Q1)
- Published
- 2 November 2026
- Study design
- Non-randomized / quasi-experimental trial
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Suresh Senan, Hongxia Cui, David R Spigel, Byoung Chul Cho, Konstantin K Laktionov, Yoshitaka Zenke, et al.
- PMID
- 42971506
- DOI
- 10.1016/j.jtho.2026.106221
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 5 November 2026): Phase III lung cancer trial informs consolidation treatment outcomes
Abstract
INTRODUCTION: In the ADRIATIC study, consolidation durvalumab significantly improved dual primary endpoints of overall and progression-free survival versus placebo for patients with limited-stage SCLC (LS-SCLC) and no progression following concurrent chemoradiotherapy (cCRT). We report post-hoc, exploratory analyses of patterns of disease progression. METHODS: Patients were randomized to receive durvalumab, durvalumab-tremelimumab (not reported), or placebo, stratified by disease stage and prophylactic cranial irradiation use, and were treated until progression or intolerable toxicity, or for up to 24 months. First site of progression (BICR per RECIST v1.1) was classified as intrathoracic (any lesion within the lungs and mediastinum) and/or extrathoracic (lesions outside the lungs, including chest wall/diaphragm). Time to progression or death for intrathoracic progression, extrathoracic progression, and brain/central nervous system progression were assessed by Kaplan‒Meier methods. RESULTS: In the durvalumab (n=264) and placebo (n=266) arms, 47.7% and 59.4% of patients, respectively, had progression; rates of intrathoracic-only progression were 27.7% and 29.3%. Extrathoracic lesions occurred in 20.1% and 30.1% of patients in the durvalumab and placebo arms, respectively; the most common site was the brain (6.8% and 12.4%). Time to intrathoracic progression or death (HR 0.81 [95% CI: 0.61‒1.08]) and time to extrathoracic progression or death (HR 0.68 [95% CI: 0.49‒0.93]), including brain progression or death (HR 0.64 [95% CI: 0.40‒1.01]), favored durvalumab versus placebo. CONCLUSION: The lower rate of extrathoracic progression and prolonged time to progression or death for intrathoracic and extrathoracic (including brain) lesions observed with durvalumab versus placebo further support consolidation durvalumab as the new standard-of-care treatment for patients with LS-SCLC without progression after cCRT.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.