Real-world efficacy and safety of first-line durvalumab combined with platinum–etoposide in extensive-stage small cell lung cancer: A single-center experience in Vietnam.

Abstract

281 Background: Durvalumab combined with platinum–etoposide is the standard first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) based on the CASPIAN trial. Real-world data in Southeast Asia remain limited. We evaluated the effectiveness and safety of this regimen in routine clinical practice in Vietnam. Methods: This single-center retrospective study included patients ≥18 years with histologically confirmed ES-SCLC and ECOG 0–1 treated with first-line etoposide–platinum plus durvalumab between July 2023 and August 2025. Treatment consisted of etoposide plus carboplatin or cisplatin with durvalumab (1500 mg every 3 weeks for 4 cycles), followed by maintenance durvalumab every 4 weeks until progression or unacceptable toxicity. Tumor response was assessed per RECIST v1.1. Survival was estimated using the Kaplan–Meier method. Adverse events were graded per CTCAE v5.0. Results: Forty patients were included. Median age was 63 years (range, 29–78); all were male and 95% were smokers. Carboplatin was used in 35/40 patients (87.5%). Liver metastases were present in 15% and brain metastases in 10%. The objective response rate was 67.5%, and disease control rate was 80%. At a median follow-up of 12.5 months, median progression-free survival was 7.0 months (95% CI, 5.5–11.7) and median overall survival was 13.5 months (95% CI, 10.9–NR). One- and two-year OS rates were 57.5% and 31%, respectively. No significant differences in OS were observed according to age, ECOG performance status, or number of metastatic sites. Grade 3 hematologic toxicities were infrequent, and immune-related adverse events were manageable, with no grade 4 events observed. Conclusions: In this real-world cohort, first-line etoposide–platinum plus durvalumab demonstrated encouraging survival outcomes and an acceptable safety profile in patients with ES-SCLC, consistent with pivotal trial data and supporting its feasibility in routine practice in Vietnam. Comparison of efficacy outcomes between CASPIAN and the current study. Study N ORR (%) mPFS (mo) mOS (mo) OS 2y (%) CASPIAN (2020) 268 68 5.1 12.9 22.9 Current study (2026) 40 67.5 7.0 13.5 31 Abbreviations: N, number of patients; ORR, objective response rate; mPFS, median progression-free survival; mOS, median overall survival; OS, overall survival; 2y, 2-year.