Top Line: Does the addition of atezolizumab to chemoradiation improve survival in limited stage small cell lung cancer?
The Study: The ADRIATIC trial showed that adjuvant durvalumab improves overall survival in patients with LS-SCLC that don’t progress after chemoradiation. LU005 was a phase 3 trial that sought to determine if concurrent and adjuvant atezolizumab improves survival in LS-SCLC. It included 544 patients with LS-SCLC who were randomized to receive concurrent chemoradiation with or without concurrent and up to 1 year of adjuvant atezolizumab. 66 Gy in 33 fractions was used in 53% and 45 Gy in 30 BID fractions in 47%. Cisplatin was used in 59%. Less than half of patients (45%) received PCI. There was no significant difference in median OS with the addition of atezolizumab (31.1 v 36.1 months). The rate of overall survival at 2 years was 63% with CRT and 59.2% with CRT + atezolizumab. There was also no improvement in median PFS with atezo (12.1 v 11.4 months). Interesting exploratory findings were that twice daily RT and PCI were associated with improved OS compared with once daily RT and no PCI, respectively.
TBL: In LU005, adding concurrent and adjuvant atezolizumab to chemoradiation did not improve response or survival outcomes in patients with limited stage SCLC. | Higgins, J Clin Oncol 2026
The Study: The ADRIATIC trial showed that adjuvant durvalumab improves overall survival in patients with LS-SCLC that don’t progress after chemoradiation. LU005 was a phase 3 trial that sought to determine if concurrent and adjuvant atezolizumab improves survival in LS-SCLC. It included 544 patients with LS-SCLC who were randomized to receive concurrent chemoradiation with or without concurrent and up to 1 year of adjuvant atezolizumab. 66 Gy in 33 fractions was used in 53% and 45 Gy in 30 BID fractions in 47%. Cisplatin was used in 59%. Less than half of patients (45%) received PCI. There was no significant difference in median OS with the addition of atezolizumab (31.1 v 36.1 months). The rate of overall survival at 2 years was 63% with CRT and 59.2% with CRT + atezolizumab. There was also no improvement in median PFS with atezo (12.1 v 11.4 months). Interesting exploratory findings were that twice daily RT and PCI were associated with improved OS compared with once daily RT and no PCI, respectively.
TBL: In LU005, adding concurrent and adjuvant atezolizumab to chemoradiation did not improve response or survival outcomes in patients with limited stage SCLC. | Higgins, J Clin Oncol 2026