Durvalumab in the Real-World Management of Extensive-Stage Small Cell Lung Cancer in Alberta: Clinical Outcomes, Treatment Patterns, and a Proof-of-Concept for Outcomes-Based Agreements

Abstract Background To assess the treatment patterns and clinical outcomes in patients with extensive stage small cell lung cancer (ES-SCLC) who received first-line (1L) durvalumab in Canada and determine whether data about a drug’s effectiveness could be generated at regular intervals to support outcomes-based agreements (OBAs). Materials and Methods This was a retrospective analysis on real-world population level data from the province of Alberta, Canada. Patients diagnosed with ES-SCLC between July 1, 2021, and July 31, 2022, were at least 18 years old at diagnosis, and received durvalumab, were included in this study. Treatment patterns and survival outcomes were collected on a quarterly analysis to replicate the data requirements for an OBA. Results The study included 68 patients, with 63 (92.6%) patients who received first-line (1L) durvalumab. With 61 (96.8%) patients discontinuing durvalumab by the data cut-off date, the median 1L treatment duration was 5.5 months. Of the patients receiving 1L durvalumab therapy, the median overall survival (OS) was 11.3 months. The 1-year and 2-year OS rates were 46% and 21%, respectively, and the median time to next treatment or death (TTNT-D) was 8.2 months. Conclusion This is the first study to assess the real-world use of durvalumab in ES-SCLC in Canada. Patients with ES-SCLC who received 1L durvalumab plus platinum-etoposide, had similar OS outcomes to those in the CASPIAN trial. Durvalumab has a meaningful role in managing ES-SCLC, and it is feasible to collect and analyze data to operationalize an OBA using existing infrastructure.