Uptake of Adjuvant Durvalumab After Definitive Concurrent Chemoradiotherapy for Stage III Nonsmall-cell Lung Cancer. (11th April 2022)

• Record Type: Journal Article
• Authors: Bryant, Alex K.; Yin, Huiying; Schipper, Matthew J.; Paximadis, Peter A.; Boike, Thomas P.; Bergsma, Derek P.; Movsas, Benjamin; Dess, Robert T.; Mietzel, Melissa A.; Kendrick, Randi; Seferi, Merita; Dominello, Michael M.; Matuszak, Martha M.; Jagsi, Reshma; Hayman, James A.; Pierce, Lori J.; Jolly, Shruti
• Is Part Of: American journal of clinical oncology. Volume 45:Number 4(2022)
• Page Start: 142
• Page End: 145
• Publication Date: 2022-04-11
• Subjects: nonsmall-cell -- immunotherapy -- radiation -- durvalumab -- real-world; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0000000000000899
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objectives: The addition of adjuvant durvalumab improves overall survival in locally advanced nonsmall-cell lung cancer (NSCLC) patients treated with definitive chemoradiation, but the real-world uptake of adjuvant durvalumab is unknown. Materials and Methods: We identified patients with stage III NSCLC treated with definitive concurrent chemoradiation from January 2018 to October 2020 from a statewide radiation oncology quality consortium, representing a mix of community (n=22 centers) and academic (n=5) across the state of Michigan. Use of adjuvant durvalumab was ascertained at the time of routine 3-month or 6-month follow-up after completion of chemoradiation. Results: Of 421 patients with stage III NSCLC who completed chemoradiation, 322 (76.5%) initiated adjuvant durvalumab. The percentage of patients initiating adjuvant durvalumab increased over time from 66% early in the study period to 92% at the end of the study period. There was substantial heterogeneity by treatment center, ranging from 53% to 90%. In multivariable logistic regression, independent predictors of durvalumab initiation included more recent month (odds ratio [OR]: 1.05 per month, 95% confidence interval [CI]: 1.02-1.08, P =0.003), lower Eastern Cooperative Oncology Group score (OR: 4.02 for ECOG 0 vs. 2+, 95% CI: 1.67-9.64, P =0.002), and a trend toward significance for female sex (OR: 1.66, 95% CI: 0.98-2.82, P =0.06). Conclusion: Adjuvant durvalumab for stage III NSCLC treated with definitive chemoradiation was rapidly and successfully incorporated into clinical care across a range of community and academic settings in the state of Michigan, with over 90% of potentially eligible patients starting durvalumab in more recent months.