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9002: Durvalumab ± tremelimumab + platinum- etoposide in first-line extensive-stage SCLC: Updated results from the phase 3 CASPIAN study Luis Paz-Ares, 1 Mikhail Dvorkin, 2 Yuanbin Chen, 3 Niels Reinmuth, 4 Katsuyuki Hotta, 5 Dmytro Trukhin, 6 Galina Statsenko, 7 Maximilian J. Hochmair, 8 Mustafa Özgüroğlu, 9 Jun Ho Ji, 10 Oleksandr Voitko, 11 Artem Poltoratskiy, 12 Francesco Verderame, 13 Libor Havel, 14 Igor Bondarenko, 15 Jon Armstrong, 16 Natalie Byrne, 16 Haiyi Jiang, 17 Jonathan W. Goldman 18 1 Hospital Universitario 12 de Octubre, Madrid, Spain; 2 BHI of Omsk Region Clinical Oncology Dispensary, Omsk, Russia; 3 Cancer & Hematology Centers of Western Michigan, Grand Rapids, MI, USA; 4 Asklepios Lung Clinic, Munich-Gauting, Germany; 5 Okayama University Hospital, Okayama, Japan; 6 Odesa Regional Oncological Dispensary, Odessa, Ukraine; 7 Omsk Regional Cancer Center, Omsk, Russian Federation; 8 Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria; 9 Istanbul University−Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey; 10 Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; 11 Kyiv City Clinical Oncological Centre, Kiev, Ukraine; 12 Petrov Research Institute of Oncology, St Petersburg, Russian Federation; 13 AO Ospedali Riuniti PO Vincenzo Cervello, Palermo, Italy; 14 Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic; 15 Dnipropetrovsk Medical Academy, Dnipro, Ukraine; 16 AstraZeneca, Cambridge, UK; 17 AstraZeneca, Gaithersburg, MD, USA; 18 David Geffen School of Medicine at UCLA, Los Angeles, CA, USA 1 Luis Paz-Ares ([email protected])

9002: Durvalumab ± tremelimumab + platinum- etoposide in first … · 2020. 5. 29. · PD-1/PD-L1 pathway to platinum -based chemotherapy has improved OS in the first -line setting

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Page 1: 9002: Durvalumab ± tremelimumab + platinum- etoposide in first … · 2020. 5. 29. · PD-1/PD-L1 pathway to platinum -based chemotherapy has improved OS in the first -line setting

9002: Durvalumab ± tremelimumab + platinum-etoposide in first-line extensive-stage SCLC:

Updated results from the phase 3 CASPIAN study Luis Paz-Ares,1 Mikhail Dvorkin,2 Yuanbin Chen,3 Niels Reinmuth,4 Katsuyuki Hotta,5 Dmytro Trukhin,6 Galina Statsenko,7

Maximilian J. Hochmair,8 Mustafa Özgüroğlu,9 Jun Ho Ji,10 Oleksandr Voitko,11 Artem Poltoratskiy,12 Francesco Verderame,13

Libor Havel,14 Igor Bondarenko,15 Jon Armstrong,16 Natalie Byrne,16 Haiyi Jiang,17 Jonathan W. Goldman18

1Hospital Universitario 12 de Octubre, Madrid, Spain; 2BHI of Omsk Region Clinical Oncology Dispensary, Omsk, Russia; 3Cancer & Hematology Centers of Western Michigan, Grand Rapids, MI, USA; 4Asklepios Lung Clinic, Munich-Gauting, Germany; 5Okayama University Hospital, Okayama, Japan; 6Odesa Regional Oncological Dispensary, Odessa, Ukraine; 7Omsk Regional Cancer Center, Omsk,

Russian Federation; 8Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Krankenhaus Nord, Vienna, Austria; 9Istanbul University−Cerrahpaşa, Cerrahpaşa School of Medicine, Istanbul, Turkey; 10Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; 11Kyiv City Clinical Oncological Centre, Kiev, Ukraine; 12Petrov Research Institute of Oncology, St Petersburg,

Russian Federation; 13AO Ospedali Riuniti PO Vincenzo Cervello, Palermo, Italy; 14Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic; 15Dnipropetrovsk Medical Academy, Dnipro, Ukraine; 16AstraZeneca, Cambridge, UK; 17AstraZeneca, Gaithersburg, MD, USA; 18David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

1Luis Paz-Ares ([email protected])

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Background

2Luis Paz-Ares

• After >3 decades of limited progress in ES-SCLC, addition of immunotherapy targeting the PD-1/PD-L1 pathway to platinum-based chemotherapy has improved OS in the first-line setting1,2

• In CASPIAN, durvalumab in combination with etoposide plus either cisplatin or carboplatin (EP) demonstrated a statistically significant improvement in OS compared with EP alone – OS HR 0.73 (95% CI 0.59–0.91; p=0.0047)1

• Durvalumab in combination with EP was approved as first-line treatment for ES-SCLC by the US FDA in March 20203 and is under review by other health authorities globally

• Here we present the primary analysis for durvalumab + tremelimumab + EP vs EP and a planned updated analysis of OS for durvalumab + EP vs EP with an additional 11 months of follow-up

1. Paz-Ares L, et al. Lancet 2019;394:1929–39; 2. Horn L, et al. N Engl J Med 2018;379:2220–93. AstraZeneca Press Release. https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2020/imfinzi-approved-in-the-us-for-extensive-stage-small-cell-lung-cancer.html

EP, platinum-etoposide; ES-SCLC, extensive-stage small-cell lung cancer; FDA, food and drug administration; OS, overall survival; PD-1, programmed cell death-1; PD-L1, programmed cell death ligand-1

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CASPIAN Study DesignPhase 3, global, randomized, open-label, active-controlled, multicenter study

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Durvalumab + tremelimumab + EP*

q3w for 4 cycles

Durvalumab‡

q4w until PD

Durvalumab + EP* q3w for 4 cycles

Primary endpoint• OS

Secondary endpoints • PFS§

• ORR§

• Safety & tolerability• PROs

R

EP*q3w for up to 6 cycles†

Stratified by planned platinum

(carboplatin vs cisplatin)

• Treatment-naïve ES-SCLC• WHO PS 0 or 1• Asymptomatic or treated and

stable brain metastases permitted

• Life expectancy ≥12 weeks • Measurable disease per

RECIST v1.1N=805 (randomized)

1:1:1Durvalumab

q4w until PD

Optional PCI†

*EP consists of etoposide 80–100 mg/m2 with either carboplatin AUC 5–6 or cisplatin 75–80 mg/m2, durvalumab dosed at 1500 mg, tremelimumab dosed at 75 mg †Patients could receive an additional 2 cycles of EP (up to 6 cycles total) and PCI at the investigator’s discretion

‡Patients received an additional dose of tremelimumab post-EP; §By investigator assessment per RECIST v1.1AUC, area under the curve; ORR, objective response rate; PCI, prophylactic cranial irradiation; PD, disease progression; PFS, progression-free survival;

PROs, patient-reported outcomes; PS, performance status; q3w, every 3 weeks; q4w, every 4 weeks; RECIST v1.1, Response Evaluation Criteria in Solid Tumors version 1.1

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Statistical Analysis

Durvalumab + EP vs EP• Primary OS endpoint met at interim analysis (63% maturity)

• α recycled to final analysis of OS for durvalumab + tremelimumab + EP vs EP

Durvalumab + tremelimumab + EP vs EP• Final analysis planned at 80% maturity

‒ 96% power based on assumed OS HR of 0.69

• At data cut-off for the final analysis (Jan 27, 2020):‒ 438 events across the durvalumab + tremelimumab + EP and

EP arms (82% maturity)‒ 2-sided α spend 4.18%* (i.e. p<0.0418 is statistically significant)

Formal statistical significance testing for PFS was only possible if both OS primary analyses were significant

4Luis Paz-Ares

D, durvalumab; IA, interim analysis; ITT, intention-to-treat; MTP, multiple testing procedure; T, tremelimumab*Adjusted for the interim analysis using Lan-DeMets (O’Brien-Fleming)

MTP at Final Analysis

At IA

D+EP vs EP (5%) PFS (ITT)

D+T+EP vs EP (5%) PFS (ITT)

α recycling

5% 2-sided

D+EP vs EP (4%)OS (ITT)

(HR at interim = 0.73)

D+T+EP vs EP (5%)OS (ITT)

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Baseline Characteristics

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D+T+EP(n=268)

D+EP(n=268)

EP(n=269)

Median age (range), years 63 (36–88) 62 (28–82) 63 (35–82)

Male, % 75.4 70.9 68.4

White / Asian / Other, % 80.2 / 17.5 / 2.4 85.4 / 13.4 / 1.1 82.2 / 15.6 / 2.2

WHO PS 0 / 1, % 40.7 / 59.3 36.9 / 63.1 33.5 / 66.5

Disease stage III / IV*, % 6.7 / 93.3 10.4 / 89.6 8.9 / 91.1

Current / Former / Never smoker, % 41.8 / 52.6 / 5.6 44.8 / 47.0 / 8.2 46.8 / 47.6 / 5.6

Brain or CNS metastases, % 14.2 10.4 10.0

Liver metastases, % 43.7 40.3 38.7

*All patients were confirmed as having ES-SCLCCNS, central nervous system

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Patient Disposition

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D+T+EP(n=268)

D+EP(n=268)

EP(n=269)

Received treatment, n 266 265 266Ongoing durvalumab, n (%) 30 (11) 32 (12) 0Completed EP / Discontinued EP†, n 206 / 58* 223 / 42 190 / 76

Received subsequent PCI‡, n (%) 7 (3) – 22 (8)Received subsequent anticancer therapy, n (%) 117 (44) 123 (46) 125 (46)

≥2 subsequent lines of therapy 31 (12) 51 (19) 49 (18)

*2 patients discontinued due to AEs during the immunotherapy infusions before receiving any EP†The most common reason for discontinuation of EP was disease progression in the D+EP and EP arms and AEs in the D+T+EP arm

‡PCI was only permitted in the EP arm at the investigator’s discretion but 7 pts in the D+T+EP arm received PCI subsequent to other study treatment; AE, adverse event

• Median duration of follow-up in censored patients: 25.1 months (range 0.1‒33.7)

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Treatment Exposure

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ChemotherapyD+T+EP(n=264*)

D+EP(n=265)

EP(n=266)

Platinum agent received†, n (%)Carboplatin 202 (76.5) 208 (78.5) 208 (78.2)Cisplatin 66 (25.0) 65 (24.5) 67 (25.2)

Median number of cycles of EP‡, n (range) 4 (1–6) 4 (1–6) 6 (1–6)Number of cycles of EP‡, n (%)

≥4 cycles 215 (81.4) 230 (86.8) 225 (84.6)6 cycles 1 (0.4) 1 (0.4) 151 (56.8)

Immunotherapy (n=266) (n=265) (n=266)Median total duration of durvalumab, weeks 23.1 28.0 –Median number of durvalumab doses, n (range) 6 (1–35) 7 (1–37) –Median total duration of tremelimumab, weeks 20.0 – –Patients receiving 5 planned tremelimumab doses, n (%) 161 (60.5) – –

*2 patients discontinued due to AEs during the immunotherapy infusions before receiving any EP†Patients were allowed to switch between carboplatin and cisplatin at the investigator’s discretion; ‡Based on etoposide exposure

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Overall Survival: D+T+EP vs EP (Primary Endpoint)

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*p≤0.0418 required for statistical significance

D+T+EP EPEvents, n/N (%) 207/268 (77.2) 231/269 (85.9)mOS, months (95% CI) 10.4 (9.6–12.0) 10.5 (9.3–11.2)HR (95% CI) 0.82 (0.68–1.00)p-value 0.0451*

No. at riskD+T+EP 268 238 200 156 114 92 80 67 47 30 11 1 0

EP 269 243 212 156 104 82 64 48 24 8 0 0 0

1.0

0 3 6 9 12 15 18 3621Time from randomization (months)

43.8%

39.3%Prob

abilit

y of

OS

0

0.2

0.4

0.6

0.8

24 27 30 33

30.7%

24.8%

23.4%

14.4%

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Overall Survival: D+T+EP vs EP Subgroup Analysis

9Luis Paz-Ares

Size of circle is proportional to the number of events across both treatment groups. *Post hoc analysis; other subgroups were pre-specified. AJCC, American Joint Committee on Cancer

HR (95% CI)All patients (n=537) 0.82 (0.68–1.00)Planned platinum agent Carboplatin (n=401)

Cisplatin (n=136)0.84 (0.67–1.04)0.79 (0.55–1.15)

Age <65 years (n=311)≥65 years (n=226)

0.76 (0.59–0.97)0.92 (0.69–1.22)

Sex Male (n=386)Female (n=151)

0.83 (0.66–1.03)0.76 (0.52–1.10)

Performance status 0 (n=199)1 (n=338)

0.79 (0.58–1.09)0.87 (0.69–1.10)

Smoking status Smoker (n=507)Non-smoker (n=30)

0.86 (0.70–1.04)0.43 (0.17–1.02)

Brain/CNS metastases Yes (n=65)No (n=472)

0.91 (0.53–1.59)0.81 (0.66–0.98)

Liver metastases* Yes (n=221)No (n=316)

0.90 (0.68–1.20)0.74 (0.58–0.96)

AJCC disease stage at diagnosis Stage III (n=42)Stage IV (n=495)

0.96 (0.47–1.88)0.81 (0.67–0.99)

Race Asian (n=89)Non-Asian (n=447)

0.86 (0.53–1.38)0.81 (0.66–1.00)

Region Asia (n=84)Europe (n=404)North and South America (n=49)

0.90 (0.55–1.46)0.78 (0.62–0.96)1.08 (0.58–2.03)

0.5 1 2

Favors D+T+EP Favors EP

0.25

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PFS and Confirmed Objective Response: D+T+EP vs EP

10Luis Paz-Ares

D+T+EP EP Events, n/N (%) 229/268 (85.4) 236/269 (87.7)mPFS*, months (95% CI)

4.9 (4.7–5.9)

5.4 (4.8–6.2)

HR (95% CI) 0.84 (0.70–1.01)

*Investigator assessed per RECIST v1.1; †One patient did not have measurable disease at baselinemDoR, median duration of response; mPFS, median progression-free survival; OR, odds ratio

D+T+EP EP ORR*, % (n/N) 58.4 (156/267†) 58.0 (156/269)mDoR, months (95% CI)

5.2 (4.9–5.6)

5.1 (4.8–5.3)

PFS Duration of Response

No. at riskD+T+EP 268 204 111 54 42 36 30 26 18 5 1 0

EP 269 195 110 33 12 9 7 7 6 1 0 0

Prop

ortio

n of

pat

ient

s in

resp

onse

Prob

abilit

y of

PFS

17.2%

3.9%

Time from confirmed objective response (months)

1.0

0

0.8

0.6

0.4

0.2

03 6 9 2112 15 18 24 27 30 33

16.9%

5.3%

Time from randomization (months)

1.0

0

0.8

0.6

0.4

0.2

03 6 9 2112 15 18 24 27 30 33

11.5%2.9%

24.9%

7.3%

No. at riskD+T+EP 156 146 61 41 37 31 26 21 10 4 1 0

EP 156 145 50 17 10 6 6 4 4 0 0 0

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Updated Overall Survival: D+EP vs EP

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D+EP EPEvents, n/N (%) 210/268 (78.4) 231/269 (85.9)mOS, months (95% CI) 12.9 (11.3–14.7) 10.5 (9.3–11.2)HR (95% CI) 0.75 (0.62–0.91)Nominal p-value 0.0032

No. at riskD+EP 268 244 214 177 140 109 85 66 41 21 8 2 0

EP 269 243 212 156 104 82 64 48 24 8 0 0 0

1.0

0 3 6 9 12 15 18 3621Time from randomization (months)

52.8%

39.3%

Prob

abilit

y of

OS

0

0.2

0.4

0.6

0.8

24 27 30 33

32.0%

24.8%

22.2%

14.4%

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Overall Survival: D+EP vs EP Subgroup Analysis

12Luis Paz-Ares

Size of circle is proportional to the number of events across both treatment groups. *Post hoc analysis; other subgroups were pre-specified

HR (95% CI)All patients (n=537) 0.75 (0.62–0.91)Planned platinum agent Carboplatin (n=402)

Cisplatin (n=135)0.79 (0.63–0.98)0.67 (0.46–0.97)

Age <65 years (n=324)≥65 years (n=213)

0.72 (0.56–0.91)0.84 (0.62–1.12)

Sex Male (n=374)Female (n=163)

0.79 (0.63–0.99)0.65 (0.45–0.93)

Performance status 0 (n=189)1 (n=348)

0.77 (0.56–1.06)0.76 (0.60–0.96)

Smoking status Smoker (n=500)Non-smoker (n=37)

0.75 (0.62–0.91)0.83 (0.41–1.71)

Brain/CNS metastases Yes (n=55)No (n=482)

0.79 (0.44–1.41)0.76 (0.62–0.92)

Liver metastases* Yes (n=212)No (n=325)

0.87 (0.66–1.16)0.68 (0.53–0.88)

AJCC disease stage at diagnosis Stage III (n=52)Stage IV (n=485)

0.83 (0.44–1.54)0.75 (0.62–0.92)

Race Asian (n=78)Non-Asian (n=458)

0.86 (0.52–1.40)0.75 (0.61–0.92)

Region Asia (n=76)Europe (n=405)North and South America (n=56)

0.87 (0.53–1.43)0.74 (0.60–0.92)0.77 (0.42–1.43)

0.5 1 2

Favors D+EP Favors EP

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Updated Progression-free Survival: D+EP vs EP

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*Investigator assessed per RECIST v1.1

• PFS was not formally tested for statistical significance • 56.8% of patients in the control arm received 6 cycles of EP

Landmark PFS, %

D+EP(n=268)

EP(n=269)

6 months 45.4 45.8

12 months 17.9 5.3

18 months 13.9 3.4

24 months 11.0 2.9

D+EP EP Events, n/N (%) 234/268 (87.3) 236/269 (87.7)mPFS*, months (95% CI) 5.1 (4.7–6.2) 5.4 (4.8–6.2)HR (95% CI) 0.80 (0.66–0.96)

No. at riskD+EP 268 220 119 55 45 40 35 24 18 8 5 0

EP 269 195 110 33 12 9 7 7 6 1 0 0

Prob

abilit

y of

PFS

17.9%

5.3%

Time from randomization (months)

1.0

0

0.8

0.6

0.4

0.2

03 6 9 2112 15 18 24 27 30 33

11.0%2.9%

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0

20

40

60

80

100

D+EP(n=268)

EP(n=269)

Updated Confirmed Objective Response: D+EP vs EP

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Odds ratio 1.53 (95% CI 1.08–2.18)

*Investigator assessed per RECIST v1.1

D+EP EP Responders, n 182 156Median DoR, months (95% CI)

5.1(4.9–5.3)

5.1(4.8–5.3)

ORR* Duration of Response

No. at riskD+EP 182 170 70 45 40 35 27 17 12 6 0 0

EP 156 145 50 17 10 6 6 4 4 0 0 0

Patie

nts

with

resp

onse

, %

13.5%

3.9%

23.2%

7.3%

Time from confirmed objective response (months)

1.0

0

0.8

0.6

0.4

0.2

03 6 9 2112 15 18 24 27 30 33

Prop

ortio

n of

pat

ient

s in

resp

onse

67.9

58.0

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Overall Survival: All Arms

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No. at riskD+T+EP 268 238 200 156 114 92 80 67 47 30 11 1 0

D+EP 268 244 214 177 140 109 85 66 41 21 8 2 0EP 269 243 212 156 104 82 64 48 24 8 0 0 0

1.0

0 3 6 9 12 15 18 3621Time from randomization (months)

Prob

abilit

y of

OS

0

0.2

0.4

0.6

0.8

24 27 30 33

30.7% 23.4%32.0%

24.8%

22.2%

14.4%

• Median duration of follow-up in censored patients: 25.1 months (range 0.1‒33.7)

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Safety Summary

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D+T+EP(n=266)

D+EP(n=265)

EP(n=266)

Any-grade all-cause AEs, n (%) 264 (99.2) 260 (98.1) 258 (97.0)

Grade 3/4 AEs 187 (70.3) 165 (62.3) 167 (62.8)

Serious AEs 121 (45.5) 85 (32.1) 97 (36.5)

AEs leading to treatment discontinuation* 57 (21.4) 27 (10.2) 25 (9.4)

Immune-mediated AEs† 96 (36.1) 53 (20.0) 7 (2.6)

AEs leading to death 27 (10.2) 13 (4.9) 15 (5.6)

Treatment-related AEs leading to death‡ 12 (4.5) 6 (2.3) 2 (0.8)

*Includes patients who permanently discontinued at least one study drug†An event that is associated with drug exposure and consistent with an immune-mediated mechanism of action, where there is no clear alternate etiology and the event required treatment with systemic

corticosteroids or other immunosuppressants and/or, for specific endocrine events, endocrine therapy; majority of immune-mediated AEs were low grade and thyroid related‡AEs assessed by the investigator as possibly related to any study treatment. Causes of death were death, febrile neutropenia, and pulmonary embolism (two patients each), and enterocolitis, general physical

health deterioration/multiple organ dysfunction syndrome, pneumonia, pneumonitis/hepatitis, respiratory failure, and sudden death (one patient each) in the durvalumab + tremelimumab + EP arm; cardiac arrest, dehydration, hepatotoxicity, interstitial lung disease, pancytopenia, and sepsis (one patient each) in the durvalumab + EP arm; pancytopenia and thrombocytopenia/haemorrhage (one patient each) in the EP arm

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Conclusions

• First-line durvalumab + EP continued to demonstrate sustained improvement in OS compared with a robust control arm that allowed up to 6 cycles of EP and the use of PCI

‒ OS HR 0.75 (95% CI 0.62–0.91; nominal p=0.0032)

‒ Sustained separation of OS curves with 22.2% vs 14.4% of patients alive at 24 months

‒ Benefit was observed across all pre-specified subgroups and key secondary efficacy outcomes

• Addition of tremelimumab to durvalumab + EP did not significantly improve outcomes in CASPIAN

• Safety findings in all arms remained consistent with the known safety profiles of all agents

• These results further support durvalumab + EP as a new standard-of-care treatment for first-line ES-SCLC offering the flexibility of platinum choice

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Acknowledgments

• The authors would like to thank the patients, their families and caregivers

• Investigators and site personnel from 209 sites in 23 countries

• This study (NCT03043872) was sponsored by AstraZeneca

• Medical writing support, in accordance with Good Publication Practice (GPP3) guidelines, was provided by Craig Turner, MSc, of Cirrus Communications (Macclesfield, UK), an Ashfield company, and was funded by AstraZeneca

18Luis Paz-Ares

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CASPIAN Investigators

Argentina: Susana Noemi Sena, Juan Jose Zarba, Emilio Batagelj, Anea Viviana Pastor, Ignacio Casarini; Austria: Otto Burghuber, Maximilian J. Hochmair, Sylvia Hartl, Bernd Lamprecht, Michael Studnicka; Brazil: Gustavo Colagiovanni Girotto, Clarissa Serodio da Rocha Baldotto, Mauro Zukin, Luis Alberto Schlittler, Peo Rafael Martins De Marchi, Carlos Fausto Nino Gorini, Aknar Calabrich, Fabricio Augusto Martinelli de Oliveira, Claudia Sette, Peo Dos Reis; Bulgaria: Assen Dudov, Violetka Venkova, Krassimir Koynov, Spartak Valev, Rumyana Ilieva, Ivan Tonev, Rositsa Krasteva, Nikolay V. Conev; China: Caicun Zhou, Yanqiu Zhao, Zhigang Han, Mengzhao Wang, Zhixiong Yang, Jie Hu, Wei Li, Jun Zhao, Jifeng Feng, Shenglin Ma, Xiangdong Zhou, Zongan Liang, Yi Hu, Yuan Chen, Minghong Bi, Yongqian Shu, Kejun Nan, Jianying Zhou, Wei Zhang, Rui Ma, Nong Yang, ChengshuiChen, Zhong Lin, Gang Wu, Jian Fang, Helong Zhang, Kai Wang, Zhendong Chen; Czech Republic: Milada Zemanova, Leona Koubkova, Libor Havel, Jaromir Roubec, VitezslavKolek, Jana Skrickova; France: Gilles Robinet, Pierre-Jean Souquet, Werner Hilgers, Christos Chouaid, Denis Moro-Sibilot, Hervé Lena; Germany: Eckart Laack, Jens Panse, Christian Grohe, Niels Reinmuth, Jürgen Alt, Christian Schulz, Helge Bischoff, Susanne Lang; Hungary: Anea Fülöp, Krisztina Bogos, Eszter Csánky, Zsolt Pápai Székely, GáborPajkos, Zsolt Horváth, Attila Somfay, Éva Somogyiné Ezer, Ibolya Laczó, Anás Telekes, Judit Kósa, György Losonczy, Zsuzsanna Pápai, Veronika Sárosi; Israel: Jair Bar, Maya Gottfried, Alona Zer Kuch, Norman Isaac Heching; Italy: Angelo Delmonte, Mauro Minelli, Marina Chiara Garassino, Anna Cecilia Bettini, Fausto Roila, Roberta Bartolucci, Francesco Verderame; Japan: Shintaro Kanda, Tatsuya Yoshida, Toyoaki Hida, Young Hak Kim, Shigeki Umemura, Koichi Goto, Hidetoshi Hayashi, Shinji Atagi, Katsuyuki Hotta, HaruhiroSaito, Makoto Nishio, Isamu Okamoto, Koichi Azuma, Shoichi Kuyama, Tadashi Maeda, Naoyuki Nogami, Yasuharu Nakahara, Hisatsugu Goto, Kenya Kanazawa, Masahiro Shinoda, Yu Hara, Masahiro Morise; Netherlands: Egbert Smit, Lizza Heniks, Jeroen Hiltermann, Agnes Staal van den Brekel, Niels Claessens, Robin Cornelissen; Poland: Dariusz Kowalski, Slawomir Mańdziuk, Andrzej Kazarnowicz, Robert Mróz, Marek Wojtukiewicz; Romania: Doina Ganea, Anei Ungureanu, Tudor Ciuleanu; Russia: Vladimir Moiseenko, Alexey Smolin, Mikhail Dvorkin, Alexander Vasilyev, Alexander Luft, Artem Poltoratskiy, Dina Sakaeva, Lyubov Vladimirova, Galina Statsenko; Slovakia: Peter Kasan, Marian Stresko, PavolDemo, Michal Urda, Jozef Chovanec, Igor Anasina, Robert Godal; South Korea: Sang-We Kim, Ki Hyeong Lee, Yun Gyoo Lee, Gyeong-Won Lee, Jong-Seok Lee, Eun Kyung Cho, Kyung Hee Lee, Joo-Hang Kim, Jun Ho Ji; Spain: Luis Paz-Ares Rodríguez, Santiago Ponce Aix, Dolores Isla Casado, Juan Ignacio Delgado Mingorance, Manuel Domine Gomez, Margarita Majem Tarruella, Maria Rosario Garcia Campelo, Alejano Navarro Mendivil, Maria Amelia Insa Molla, Marta Lopez Brea, Teresa Morán Bueno; Taiwan: Chao-Hua Chiu, Yu-Feng Wei, Gee-Chen Chang, Chien-Te Li, Yen-Hsun Chen, Te-Chun Hsia, Shang-Yin Wu, Kang-Yun Lee, Chin-Chou Wang; Turkey: Irfan Çiçin, Mustafa Özgüroğlu, TuncayGöksel, Mustafa Erman, Ahmet Alacacıoğlu, Ahmet Demirkazik; Ukraine: Oleksandr Voitko, Nataliia Voitko, Ihor Vynnychenko, Yaroslav Shparyk, Serhii Shevnia, Anna Kryzhanivska, Hryhoriy Adamchuk, Igor Bondarenko, Oleksii Kolesnik, Grygorii Ursol, Dmytro Trukhin, Yuriy Ostapenko; United States of America: Eric Schaefer, Helen Ross, Anne Chiang, Jeanna Knoble, Rodney Jamil, Kailhong Mi, Petros Nikolinakos, Afshin Dowlati, Shailena Lakhanpal, Basir Haque, Steven Powell, Christopher Sumey, Jeffrey Schneider, Joseph Spahr, Michael Williamson, Shaker Dakhil, Yuanbin Chen, Winston Chua, Sunil Babu, Jonathan W. Goldman, David Spigel, Joseph Stilwill

19Luis Paz-Ares