New Treatment Options Offer Hope for Those with Small Cell Lung Cancer

Posted: July 22, 2020 | Word Count: 1,638

Karen was just starting to settle into retirement when she began feeling tired and drained. Before her retirement Karen had worked as a nurse in the military and then in a factory, all while raising a family, so she wasn’t too surprised when it seemed like her busy life might finally be catching-up with her. But when she began to notice a tightness and heaviness in her chest and shoulder blades, Karen decided it was time to see her doctor.

Thinking that she might have a respiratory infection, or at worst pneumonia, Karen was shocked when her doctor told her that he suspected lung cancer. Additional tests and a visit to an oncologist confirmed a diagnosis of extensive-stage small-cell lung cancer (ES-SCLC), an aggressive and fast-growing form of lung cancer. Consistent with two-thirds of newly diagnosed patients, Karen was diagnosed with extensive-stage disease—meaning the cancer had spread to both lungs or other more distant parts of her body.

“I was shocked and scared,” Karen said. “So many thoughts went through my mind, like ‘what’s going to happen to my daughter? What’s going to happen to my son and my grandkids?’”

While it makes up approximately 15% of lung cancer cases, SCLC tends to grow and spread more rapidly compared to the other forms of lung cancer and it is often not diagnosed until a later stage. As a result, the overall five-year survival rate is just 6%. Patients with SCLC have traditionally had limited treatment options, and while many respond well to initial chemotherapy, for most the cancer eventually returns and progresses rapidly.

“Unfortunately, not only is small cell lung cancer an especially aggressive disease but finding new medicines to improve outcomes has also proven particularly difficult,” said Yuanbin Chen, MD, PhD, oncologist at Cancer & Hematology Centers of Western Michigan and Karen’s oncologist. “Because of this, patients with small cell lung cancer face a poor prognosis, making research and the development of new treatment options critical.”

Fortunately, ongoing research, clinical trials and new therapies are helping to bring patients and doctors more options and new hope. In March 2020, the US Food and Drug Administration (FDA) approved the immunotherapy treatment IMFINZI® (durvalumab), in combination with the chemotherapy medicines etoposide and either carboplatin or cisplatin (platinum-etoposide), as a 1st-line treatment for adults with extensive-stage small cell lung cancer (ES-SCLC).

The approval was based on results from a clinical trial that showed people taking IMFINZI plus chemotherapy lived significantly longer than people taking chemotherapy alone. In the trial, people receiving IMFINZI plus chemotherapy had a 27% lower risk of death. The median overall survival was 13.0 months for IMFINZI plus chemotherapy vs 10.3 months for chemotherapy alone. Median is the middle number in a range of numbers. The study also found that 68% of people taking IMFINZI plus chemotherapy saw their tumors shrink and 58% of people taking chemotherapy alone saw their tumors shrink.

IMFINZI may not work for everyone. IMFINZI may cause serious side effects, including lung, liver, intestinal, hormone gland, kidney, and skin problems. Tell your doctor if you have any side effect that bothers you or that does not go away. See full safety information below.

After discussing her diagnosis and treatment options, Karen and Dr Chen decided to enroll Karen in the CASPIAN clinical trial. For Karen, it was not just about finding new hope, but wanting to help make a difference for others who would face this disease.

“I chose to join the clinical trial because I wanted to try to help other people besides myself,” said Karen. “I knew that it may or may not help me, but I also thought, if it doesn’t help me, maybe I’ll help someone else down the road.”

After receiving treatment with IMFINZI and chemotherapy, Karen’s first CAT scan showed that her tumor had shrunk around 30%. As Karen continued her treatment, her next CAT scan showed that it had shrunk again. Karen continues to receive treatment every four weeks, and has done so for longer than two years from her diagnosis - cherishing the time she's had with her family without noticeable cancer symptoms.

“I just take one day at a time and am in touch with my kids and grandkids every day,” said Karen. “I’m a fighter and I want to hang around as long as I can.”

“I think patients like Karen can help give others facing small cell lung cancer hope,” said Dr Chen. “Her story highlights why it’s important for patients and doctors to discuss all available treatment options.”

Important Safety Information

What is the most important information I should know about IMFINZI?

IMFINZI is a medicine that may treat certain types of lung cancer by working with your immune system.

IMFINZI can cause your immune system to attack normal organs and tissues and can affect the way they work. These problems can sometimes become serious or life-threatening and can lead to death.

Call or see your healthcare provider right away if you develop any symptoms of the following problems or if these symptoms get worse:

Lung problems (pneumonitis). Signs and symptoms may include new or worsening cough, shortness of breath, and chest pain.

Liver problems (hepatitis). Signs and symptoms may include yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach area (abdomen), drowsiness, dark urine (tea colored), bleeding or bruising more easily than normal, and feeling less hungry than usual.

Intestinal problems (colitis). Signs and symptoms may include diarrhea or more bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; and severe stomach-area (abdomen) pain or tenderness.

Hormone gland problems (especially the thyroid, adrenals, pituitary, and pancreas). Signs and symptoms that your hormone glands are not working properly may include headaches that will not go away or unusual headaches; extreme tiredness; weight gain or weight loss; dizziness or fainting; feeling more hungry or thirsty than usual; hair loss; feeling cold; constipation; your voice gets deeper; urinating more often than usual; nausea or vomiting; stomach-area (abdomen) pain; and changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.

Kidney problems, including nephritis and kidney failure. Signs of kidney problems may include decrease in the amount of urine, blood in your urine, swelling of your ankles, and loss of appetite.

Skin problems. Signs may include rash, itching, and skin blistering.

Problems in other organs. Signs and symptoms may include neck stiffness; headache; confusion; fever; chest pain, shortness of breath, or irregular heartbeat (myocarditis); severe or persistent muscle pain; severe muscle weakness; changes in mood or behavior; low red blood cells (anemia); excessive bleeding or bruising; blurry vision, double vision, or other vision problems; and eye pain or redness.

Severe infections. Signs and symptoms may include fever, cough, frequent urination, pain when urinating, and flu-like symptoms.

Severe infusion reactions. Signs and symptoms may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, fever, feeling like passing out, back or neck pain, and facial swelling.

Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with IMFINZI. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may delay or completely stop treatment with IMFINZI if you have severe side effects.

Before you receive IMFINZI, tell your healthcare provider about all of your medical conditions, including if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant; have lung or breathing problems; have liver problems; or are being treated for an infection.

If you are pregnant or plan to become pregnant, tell your healthcare provider. IMFINZI can harm your unborn baby. If you are able to become pregnant, you should use an effective method of birth control during your treatment and for at least 3 months after the last dose of IMFINZI. Talk to your healthcare provider about which birth control methods to use. Tell your healthcare provider right away if you become pregnant during treatment with IMFINZI.

If you are breastfeeding or plan to breastfeed, tell your healthcare provider. It is not known if IMFINZI passes into breast milk. Do not breastfeed during treatment with IMFINZI and for at least 3 months after the last dose of IMFINZI.

Tell your healthcare provider about all the medicines you take. This includes prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of IMFINZI?

IMFINZI can cause serious side effects (see above).

The most common side effects of IMFINZI when used with other anticancer medicines with SCLC include: nausea, hair loss, and feeling tired or weak.

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of IMFINZI. Ask your healthcare provider or pharmacist for more information.

Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

You may report side effects related to AstraZeneca products by clicking here.

Please see complete Prescribing Information, including Patient Information (Medication Guide).

What is IMFINZI?

IMFINZI is a prescription medicine used to treat adults with a type of lung cancer called small cell lung cancer (SCLC). IMFINZI may be used with the chemotherapy medicines etoposide and carboplatin or cisplatin as your first treatment when your SCLC has spread within your lungs or to other parts of the body (extensive-stage small cell lung cancer, or ES-SCLC).

It is not known if IMFINZI is safe and effective in children.

To learn more about IMFINZI for extensive-stage small cell lung cancer, visit:

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