IMforte: outcomes after subsequent therapy

In a poster at the European Lung Cancer Congress (ELCC) in Copenhagen, interesting new data from the phase III IMforte study were presented. This trial evaluated maintenance therapy with atezolizumab plus lurbinectedin versus atezolizumab alone in patients with extensive-stage small cell lung cancer (ES-SCLC) who did not progress after induction treatment with carboplatin, etoposide, and atezolizumab. The primary study previously demonstrated significant improvements in both progression-free survival (PFS) and overall survival (OS) with the combination strategy, with hazard ratios of 0.73 and 0.54, respectively.

The analysis presented at ELCC focused on subsequent treatment patterns and outcomes following disease progression. Most patients received platinum-based chemotherapy in the second-line setting, with a higher proportion in the combination arm compared to the atezolizumab-alone arm. Importantly, the time to initiation of second-line therapy was longer in the experimental arm, which is in line with the observed PFS benefit and suggests a prolonged platinum-sensitive interval.

Notably, 13% of patients in the control arm received lurbinectedin as second-line therapy. These patients achieved a median OS exceeding nine months from the start of second-line treatment, compared to less than seven months with other 2^nd line regimens. Despite this activity in the second-line setting, adjusted analyses accounting for crossover and survival bias confirmed that the OS benefit remained in favor of upfront lurbinectedin combined with atezolizumab. As such, these findings reinforce the clinical value of early integration of lurbinectedin into maintenance therapy for patients with ES-SCLC.