On Saturday 24 October 2026, researchers reported that combining Amgen's drug Imdelltra with AstraZeneca's immunotherapy Imfinzi cut the risk of death by 58 percent compared with Imfinzi alone in patients with extensive-stage small cell lung cancer, with patients living a median of 21.1 months against 12.7 months, in results presented at the European Society for Medical Oncology meeting in Madrid and published in the New England Journal of Medicine.
Illustration: Immune cells attacking lung cancer cells, concept illustration.
What Happened
The results come from a Phase 3 trial of 563 patients with extensive-stage small cell lung cancer, a very aggressive and hard-to-treat disease. Imfinzi is currently the standard of care following chemotherapy for patients whose cancer does not worsen after initial chemotherapy. In the trial, patients given both drugs lived for a median of 21.1 months, compared with 12.7 months for those treated only with Imfinzi, according to Reuters reporting of the data. The combination reduced the risk of death by 58 percent compared with the AstraZeneca drug alone.
Amgen's chief medical officer, Paul Burton, called the results "unprecedented in advancing the treatment of extensive-stage small cell lung cancer," according to Reuters, adding: "If you give Imdelltra earlier and earlier, you get bigger clinical benefit." Amgen had previously announced that the Phase 3 study was successful, but the full results — the survival figures, the patient numbers and the peer-reviewed publication — were released with the Madrid presentation on 24 October.
The finding matters because small cell lung cancer progresses fast and has seen far fewer treatment advances than other lung cancers. Extensive-stage disease means the cancer has spread widely, and options after initial chemotherapy have historically been limited. A median survival gain of more than eight months in this setting is, by the standards of this disease, a large step.
Illustration: A doctor discussing treatment options with a patient, concept illustration.
Background
The two drugs work in complementary ways. Imdelltra belongs to a class called bispecific antibodies, designed to pull immune system T cells into direct contact with cancer cells so the immune system can destroy them. Imfinzi is an older type of immunotherapy that essentially blocks the mechanism tumours use to hide from immune-system assault. Used together, the idea is that one drug exposes the cancer to the immune system while the other brings the immune system's killers to it.
Imdelltra is already approved in the United States for adults in the advanced stages of small cell lung cancer whose disease has worsened despite chemotherapy, based on earlier data showing that it reduced the risk of death by 40 percent in that later-line setting. The new trial moves the drug earlier in treatment — combining it with the current standard after initial chemotherapy, rather than waiting until the cancer has worsened again. That earlier-use strategy is central to Amgen's argument: the company says the benefit grows the earlier the drug is given.
Small cell lung cancer accounts for a minority of lung cancers but is among the most aggressive, with a tendency to spread early and return quickly after treatment. Lung cancer overall remains one of the world's leading causes of cancer death, which is why even incremental survival gains in its hardest-to-treat forms attract close attention at major oncology meetings such as ESMO.
Why It Matters
For patients and clinicians, the trial offers a potential new standard in a disease where standards have barely moved. If regulators approve the combination for earlier use, doctors would have a regimen that, in trial conditions, extended median survival by more than eight months and cut the risk of death by well over half compared with today's standard. That is the kind of result that changes treatment guidelines, not just conference discussion.
For the wider field, the trial is another sign that bispecific antibodies — drugs engineered to grab two targets at once — are becoming a serious pillar of cancer treatment alongside traditional chemotherapy and checkpoint immunotherapy. The approach is being tested across many cancers, and a clear win in small cell lung cancer, a disease long considered stubbornly resistant, will encourage further combinations.
There is also a commercial dimension that patients and health systems will watch closely. Imdelltra's United States list price is about 30,000 dollars per cycle, or over 390,000 dollars a year, according to Reuters, and Wall Street analysts have estimated annual sales reaching more than 2.5 billion dollars by 2030, according to LSEG data cited by Reuters. Those figures raise familiar questions about access: a drug that works best when given earlier will also be given for longer, and health systems will have to weigh the survival benefit against the cost, especially outside the United States.
Illustration: Researchers studying cancer cells in a laboratory, concept illustration.
What Happens Next
The next step is regulatory. Amgen will be expected to submit the full trial data to regulators, including the United States Food and Drug Administration and the European Medicines Agency, seeking approval for Imdelltra in combination with Imfinzi in this earlier treatment setting. Regulators will examine not only the survival benefit but also safety: bispecific antibodies can cause significant side effects, including immune reactions, and the balance of benefit and risk in the full trial population will determine how widely the combination can be used.
Oncology guidelines bodies will also review the data. If the combination is adopted as a new standard after initial chemotherapy, it would reshape the treatment pathway for extensive-stage small cell lung cancer, pushing Imdelltra from a later-line option to a front-line combination partner. Doctors will want to see detailed subgroup data — which patients benefited most, and whether the benefit held across age groups and disease burdens — before changing practice.
Patients should note that trial results are not yet a treatment prescription. The combination is not approved for this earlier use until regulators act, and individual suitability depends on a patient's full medical picture. Anyone with small cell lung cancer who reads about the trial should discuss it with their own oncology team rather than seeking the drugs outside a clinical setting. Further presentations and the full New England Journal of Medicine paper will give clinicians the detail they need to make those judgements.
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FAQ
What did the trial find?
In 563 patients with extensive-stage small cell lung cancer, Imdelltra combined with Imfinzi reduced the risk of death by 58 percent compared with Imfinzi alone, with median survival of 21.1 months against 12.7 months.
What are Imdelltra and Imfinzi?
Imdelltra is Amgen's bispecific antibody, designed to bring immune T cells into contact with cancer cells. Imfinzi is AstraZeneca's immunotherapy and the current standard of care after chemotherapy when the disease has not worsened.
Where were the results presented?
The full results were presented at the European Society for Medical Oncology meeting in Madrid on 24 October 2026 and published in the New England Journal of Medicine.
Is the combination already approved for this use?
No. Imdelltra is approved in the United States for advanced small cell lung cancer that has worsened despite chemotherapy, but the earlier combination use reported here still requires regulatory review.
How much does Imdelltra cost?
According to Reuters, its United States list price is about 30,000 dollars per cycle, or over 390,000 dollars a year. Actual costs to patients and health systems vary by country and coverage.
Sources
- Reuters, "Amgen drug combined with immunotherapy extends survival in lung cancer trial", 24 October 2026.
- New England Journal of Medicine, full results of the 563-patient Phase 3 trial, published 24 October 2026.
- European Society for Medical Oncology meeting, Madrid, trial presentation, 24 October 2026.
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