Clinical Relevance of IMforte Survival Data in ES-SCLC

Ticiana Leal, MD Winship Cancer Institute of Emory University | Stephen Liu, MD Georgetown Lombardi Comprehensive Cancer Center | Rahul Gosain, MD, MBA Wilmot Cancer Institute | Rohit Gosain, MD Roswell Park Comprehensive Cancer Center

October 13, 2025

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Key Points

  • The phase 3 IMforte trial builds upon earlier advances in first-line treatment for extensive-stage small cell lung cancer (ES-SCLC) with lurbinectedin plus atezolizumab as a maintenance therapy.

  • This intensified maintenance approach builds upon earlier explorations of immunotherapy in the first-line setting.

  • Lurbinectedin may not be appropriate in patients who don’t recover blood counts or who experience disease progression.

Interpreting and Applying IMforte Data in Practice

Findings from the phase 3 IMforte trial led to the approval of lurbinectedin plus atezolizumab for first-line maintenance therapy in patients with ES-SCLC after induction therapy. On the Oncology Brothers podcast, cohosts Rahul Gosain, MD, MBA, of Wilmot Cancer Institute, and Rohit Gosain, MD, of Roswell Park Comprehensive Cancer Center, spoke with three clinical oncologists to discuss the impact of the approval and the applicability of the regimen.

“This trial is clearly showing clinically significant improvement in terms of progression-free survival and overall survival,” said Ticiana Leal, MD, of Winship Cancer Institute of Emory University. “This is a very difficult to treat disease, and while we had gains from immunotherapy in combination with chemotherapy and as maintenance, this builds upon those.” 

IMforte showed the maintenance therapy approach improved survival outcomes for patients with ES-SCLC in the first line, but the doctors discussed whether some patients should not be considered for lurbinectedin plus atezolizumab after induction. 

Notably, it may not be the most optimal strategy in patients who experience prolonged cytopenias or remain too frail after induction, said Stephen Liu, MD, of Georgetown Lombardi Cancer Center. Additionally, “if someone is progressing, we don’t talk about maintenance therapy, we talk about second-line treatment, it really would be a different strategy,” Dr. Liu said.