In this study, people newly diagnosed with extensive-stage small-cell lung cancer received chemotherapy together with either the immunotherapy drug atezolizumab or a placebo (dummy drug). Adding atezolizumab helped people live longer on average (12.3 months versus 10.3 months) and kept their disease from getting worse for longer. The side effects matched what was already known about these drugs.
Extensive-stage SCLC, no prior chemotherapy; ECOG 0–1
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Induction: 4 cycles of 21 days | |||
| Atezolizumab | 1200 mg | IV (first infusion over 60 min, then 30 min) | Day 1 (before chemotherapy) |
| Carboplatin | AUC 5 | IV | Day 1 |
| Etoposide | 100 mg/m² | IV | Days 1, 2 and 3 |
| Maintenance | |||
| Atezolizumab | 1200 mg every 3 weeks (or 840 mg every 2 weeks or 1680 mg every 4 weeks) | IV | Day 1 |
Source: FDA label for atezolizumab; trial.
On the page “Lung cancer” · Small cell lung cancer: first-line
Extensive-stage small cell lung cancer, first line
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Induction: up to 4 cycles | |||
| Atezolizumab | 1200 mg | IV, before chemotherapy | Day 1 |
| Induction | |||
| Carboplatin | AUC 5 mg/mL×min | IV | Day 1 |
| Etoposide | 100 mg/m² | IV | Days 1 to 3 |
| Maintenance | |||
| Atezolizumab | 840 mg every 2 weeks, or 1200 mg every 3 weeks, or 1680 mg every 4 weeks | IV | |
Chemotherapy doses are those of the IMpower133 trial in the label. For maintenance without progression after induction, atezolizumab 1200 mg with lurbinectedin 3.2 mg/m² IV every 3 weeks (IMforte trial) is also approved; in IMforte, 84% of patients received prophylactic G-CSF.
On the page “Atezolizumab (Tecentriq)” · Combination regimens (FDA label)
Extensive-stage small cell lung cancer
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Phase 1: 4 cycles | |||
| Carboplatin | AUC 5 | IV | Day 1 |
| Etoposide | 100 mg/m² | IV | Days 1 to 3 |
| Atezolizumab | 1200 mg | IV | Day 1 |
| Phase 2 | |||
| Atezolizumab | 1200 mg | IV | Every 21 days |
Doses as in IMpower133.
Dose source:.
On the page “Carboplatin-etoposide with atezolizumab or durvalumab in small cell lung cancer”
By regimen
| Drug | Dose | Route | Schedule |
|---|---|---|---|
| Testicular | |||
| Etoposide | 50 to 100 mg/m² daily on days 1 to 5 (or 100 on days 1, 3 and 5) | IV over 30 to 60 minutes | Every 3 to 4 weeks |
| Small cell lung | |||
| Etoposide | 35 mg/m² daily for 4 days to 50 mg/m² daily for 5 days | IV | Every 3 to 4 weeks |
Rapid infusion causes hypotension; give over at least 30 minutes. Reduce the dose in renal impairment. Many current lung regimens use 80 to 100 mg/m² on days 1 to 3.
Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.
Induction (4 cycles of 21 days): atezolizumab 1200 mg IV day 1 + carboplatin IV targeting AUC 5 mg/mL·min day 1 + etoposide 100 mg/m² IV days 1, 2 and 3 (on day 1 in this order: atezolizumab, carboplatin, then etoposide).
Maintenance (from cycle 5): atezolizumab 1200 mg IV day 1 every 21 days until persistent radiographic progression, symptomatic deterioration, intolerable toxicity or lack of clinical benefit; continuation beyond RECIST progression was allowed (201 patients).
Induction (4 cycles of 21 days): placebo IV day 1 + carboplatin AUC 5 day 1 + etoposide 100 mg/m² IV days 1, 2 and 3. Maintenance: placebo IV day 1 every 21 days until progression or intolerable toxicity (202 patients).
Source of the regimen details: ClinicalTrials.gov NCT02763579 (description of arms and interventions) and the FDA label for Tecentriq (DailyMed, sections 6 and 14.2, October 2026 version)
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Patients with extensive-stage small-cell lung cancer who had not previously received chemotherapy for extensive-stage disease, with ECOG 0 or 1. Exclusion criteria (FDA label): active or untreated brain metastases, history of autoimmune disease, a live vaccine within the past 4 weeks and systemic immunosuppressive drugs within the past 1 week. Randomisation was stratified by sex, ECOG and presence of brain metastases.
The two primary endpoints were investigator-assessed progression-free survival and overall survival in the intention-to-treat (ITT) population.
The safety profile of atezolizumab with carboplatin and etoposide was consistent with the known profile of each drug, and no new findings were seen. According to the FDA label (198 patients): serious adverse events 37% (pneumonia 4.5%, neutropenia 3.5%, febrile neutropenia 2.5%, thrombocytopenia 2.5%); fatal adverse events 2%; atezolizumab discontinuation due to adverse events 11% (infusion reaction 2.5%); atezolizumab interruption 59% (mainly neutropenia 22% and anaemia 9%). Fatigue/asthenia 39% (grade 3–4: 5%) versus 33% (3%).
Based on the abstract, adding atezolizumab to carboplatin and etoposide chemotherapy in the first-line treatment of extensive-stage small-cell lung cancer significantly improved overall survival and progression-free survival. The status of drug approvals and guideline recommendations should be checked in up-to-date sources.
The abstract does not mention the study's limitations. Progression-free survival was investigator-assessed. The exact rate of grade 3 or higher adverse events is not reported in the abstract and should be checked in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.
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