Tarlatamab added to durvalumab maintenance in extensive-stage SCLC: median survival 21.1 months against 12.7

The edition in brief

DeLLphi-305 randomised 563 patients with extensive-stage small-cell lung cancer, free of progression after chemoimmunotherapy, to tarlatamab plus durvalumab or durvalumab alone as maintenance. At interim analysis median overall survival was 21.1 against 12.7 months (HR 0.42, 0.32–0.54) and progression-free survival 7.4 against 1.9 months; grade 3 or worse adverse events were 46.8% against 40.6%, and nearly half had cytokine release syndrome, mostly grade 1–2. In Krascendo 1, 338 patients with previously treated KRAS G12C-mutated NSCLC were randomised to divarasib or sotorasib/adagrasib: median progression-free survival 9.8 against 5.7 months (HR 0.58), overall survival 17.7 against 12.0 months (HR 0.56), response 58.4% against 32.3%, with fewer grade 3–4 treatment-related events. VOLGA randomised 695 cisplatin-ineligible or declining patients with muscle-invasive bladder cancer to perioperative durvalumab with three cycles of neoadjuvant enfortumab vedotin, the same plus tremelimumab, or cystectomy alone. Two-year event-free survival was 63.5% with durvalumab–enfortumab vedotin against 45.1% (HR 0.51) and overall survival 78.4% against 69.4% (HR 0.58), with grade 3 or worse events in 71.1% against 50.2%.