New results from a large clinical trial show that the immunotherapy drug durvalumab (Imfinzi) can prolong survival in some people with advanced small cell lung cancer (SCLC). In the study, treatment with durvalumab combined with a standard chemotherapy regimen increased overall survival in patients with newly diagnosed advanced SCLC by approximately 3 months compared with those treated with standard chemotherapy alone. Although the improvement in survival with immunotherapy was modest, it is noteworthy because SCLC has been such a recalcitrant disease, said Anna Farago, M.D., Ph.D., a lung cancer specialist at Massachusetts General Hospital Cancer Center, who was not involved in the trial. “We now have two studies that show there is a benefit to adding immunotherapy to chemotherapy for patients with previously untreated SCLC,” Dr. Farago said. In March 2019, the Food and Drug Administration approved the immunotherapy drug atezolizumab (Tecentriq) in combination with standard chemotherapy for the initial treatment of advanced SCLC, based on results from a trial reported in September 2018. Results from the study testing durvalumab, known as the CASPIAN trial, align with those earlier results. Both drugs are a type of immunotherapy known as immune checkpoint inhibitors. The CASPIAN trial results were presented in September at the World Conference on Lung Cancer (WCLC) in Barcelona, Spain, and published October 4 in The Lancet. “CASPIAN underlines the therapeutic value of chemoimmunotherapy in patients with [advanced] SCLC as a new standard of care,” wrote Thorsten Oliver Goetze, M.D., of the Institute of Clinical Cancer Research in Frankfurt, Germany, in an accompanying editorial. The trial also “raises further questions” for future clinical trials to answer, Dr. Goetze added, including how best to use chemotherapy in combination with checkpoint inhibitors.