A new study indicates that the immune checkpoint inhibitor, durvalumab, may offer additional treatment options for patients with small cell lung cancer (SCLC). However, the cost of the treatment raises questions regarding sustainability and access. These findings were published in the December 19, 2025, issue of JCO Global Oncology.
Background on Small Cell Lung Cancer
SCLC is an aggressive form of lung cancer, accounting for approximately 15% of cases. It is characterized by rapid progression and a poor prognosis, with historical treatment involving chemotherapy and radiation. Five-year survival rates range from 25% to 30%.
Durvalumab Trial Results
Durvalumab has been identified as a promising addition to the treatment landscape for limited-stage SCLC. The ADRIATIC trial evaluated durvalumab as a maintenance therapy following chemoradiation. The trial showed an extended overall survival of 66.1 months with durvalumab, compared to 57.8 months with standard care. Progression-free survival also improved, reaching 40.2 months versus 31.8 months.
Dr. Chinmay Jani, first author on the study, stated that durvalumab represents a significant development in maintenance therapy for SCLC, noting survival improvements.
Cost-Effectiveness Analysis
The study determined that durvalumab therapy costs $163,722, in contrast to $25,816 for standard care. The incremental cost-effectiveness ratio (ICER) was calculated at $383,069 per quality-adjusted life year (QALY), which exceeds the U.S. willingness-to-pay threshold of $150,000/QALY.
Dr. Gilberto Lopes, chief of the Division of Medical Oncology at Sylvester, emphasized that cost-effectiveness influences patient access and that strategies are needed to make medical innovations sustainable. The analysis also indicated that for patients with extrathoracic progression, durvalumab approached cost-effectiveness standards, with an ICER of $151,137/QALY, suggesting the potential for precision medicine to optimize outcomes and affordability.