Real world data of durvalumab consolidation after chemoradiotherapy in stage III non-small-cell lung cancer. (August 2020)

• Record Type: Journal Article
• Authors: Jung, Hyun Ae; Noh, Jae Myoung; Sun, Jong-Mu; Lee, Se-Hoon; Ahn, Jin Seok; Ahn, Myung-Ju; Pyo, Hongryull; Ahn, Yong Chan; Park, Keunchil
• Is Part Of: Lung cancer. Volume 146(2020)
• Page Start: 23
• Page End: 29
• Publication Date: 2020-08
• Subjects: Concurrent chemo-radiotherapy -- Durvalumab -- Consolidation -- Non-small-cell lung cancer; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2020.05.035
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Real world data showed 55.3 % of patients did not meet the criteria of the PACIFIC study. The incidence of grade 3 radiation pneumonitis was 18.2 % in durvalumab versus 2.5 % in observation. Active surveillance and treatment for radiation pneumonitis were required. Abstract: Objectives: The PACIFIC study demonstrated the benefits of durvalumab consolidation on progression-free survival (PFS) and overall survival (OS) among patients with unresectable locally advanced non-small-cell lung cancer (LA-NSCLC). However, in real-world practice, patients with unresectable LA-NSCLC are heterogeneous with diverse tumor burdens and clinical factors; thus, it is important to examine the effectiveness and side effects of durvalumab when used in real clinical practice. Materials and methods: We investigated the efficacy of durvalumab consolidation and the incidence of radiation pneumonitis in patients who received concurrent chemo-radiotherapy (CCRT) for unresectable LA-NSCLC in a single institute. Results: Overall, 55.3 % of patients did not meet the criteria of the PACIFIC study; however, they still received consolidation durvalumab in real-world practice. Durvalumab consolidation was associated with favorable PFS in the total population as well as in the subgroup of patients who did not meet the criteria of the PACIFIC study. However, radiation pneumonitis occurred more frequently in the durvalumab group, especially within 3–6 months after CCRT. The incidence of grade 3 radiation pneumonitis was 14.3 % in the durvalumab group versus 2.5 % in the observation group. Conclusions: Durvalumab consolidation was associated with favorable PFS in patients with LA-NSCLC in clinical practice. However, careful selection of candidates for durvalumab treatment and active surveillance and appropriate management for radiation pneumonitis are needed.