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Immune Checkpoint Inhibitors (ICIs) Landscape

Focus - Small Cell Lung Cancer Indication

SCLC is an unforgiving, highly aggressive variant of lung cancer. It accounts for approximately 15% of lung cancer cases globally and is also a major cause of cancer-related deaths. Chemotherapy has been the mainstay in SCLC management. While the response rate to chemotherapy is high, notably, almost all patients relapse after a few months (PFS is typically 4.0 - 5.5 months).

Immunotherapy, which changed the treatment paradigm in Melanoma and NSCLC, has shown only modest benefits in SCLC patients. ​The latest positive result in the first line was reported from the IMpower 133 trial in which the addition of atezolizumab to chemotherapy resulted in 2 months of overall survival benefit over chemotherapy alone (12.3 months vs 10.3 months) in extensive-stage SCLC patients. These results were the first such improvement reported in about 30 years. Based on these results, FDA approved atezolizumab + chemotherapy for first-line treatment.

We had three specific objectives

We analyzed 104 relevant clinical trials

And identified 28 PD-1/PD-L1 inhibitors

21 PD-1 Inhibitors 1 Bi-specific PD-1/PD-L1 inhibitor 06 PD-L1 Inhibitors

More than 80% of trials involve PD-1 or PD-L1 inhibitors

Bringing everything together

The initial gains observed with ICIs need to be actively followed up by novel combination strategies. While many of the trials are investigating general combinations, there are also several trials that are probing novel combinations (+vaccine, +autologous cell therapy, and others).


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