Real-world outcomes with durvalumab after chemoradiotherapy in patients with unresectable stage III NSCLC: interim analysis of overall survival from PACIFIC-R.

PD-L1 durvalumab immunotherapy locally advanced NSCLC real-world evidence

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
03 Jun 2024
Historique:
received: 23 11 2023
revised: 10 04 2024
accepted: 12 04 2024
medline: 5 6 2024
pubmed: 5 6 2024
entrez: 4 6 2024
Statut: aheadofprint

Résumé

Based on the findings of the PACIFIC trial, consolidation durvalumab following platinum-based chemoradiotherapy (CRT) is a global standard of care for patients with unresectable, stage III non-small-cell lung cancer (NSCLC). An earlier analysis from the ongoing PACIFIC-R study (NCT03798535) demonstrated the effectiveness of this regimen in terms of progression-free survival (PFS). Here, we report the first planned overall survival (OS) analysis. PACIFIC-R is an observational/non-interventional, retrospective study of patients with unresectable, stage III NSCLC who started durvalumab (10 mg/kg intravenously every 2 weeks) within an AstraZeneca-initiated early access program between September 2017 and December 2018. Primary endpoints are OS and investigator-assessed PFS, estimated using the Kaplan-Meier method. By 30 November 2021, the full analysis set included 1154 participants from 10 countries (median follow-up in censored patients: 38.7 months). Median OS was not reached, and the 3-year OS rate was 63.2% (95% confidence interval 60.3% to 65.9%). Three-year OS rates were numerically higher among patients with programmed death-ligand 1 (PD-L1) expression on ≥1% versus <1% of tumor cells (TCs; 67.0% versus 54.4%) and patients who received concurrent CRT (cCRT) versus sequential CRT (sCRT) (64.8% versus 57.9%). PACIFIC-R data continue to provide evidence for the effectiveness of consolidation durvalumab after CRT in a large, diverse, real-world population. Better outcomes were observed among patients with PD-L1 TCs ≥1% and patients who received cCRT. Nevertheless, encouraging outcomes were still observed among patients with TCs <1% and patients who received sCRT, supporting use of consolidation durvalumab in a broad population of patients with unresectable, stage III NSCLC.

Sections du résumé

BACKGROUND BACKGROUND
Based on the findings of the PACIFIC trial, consolidation durvalumab following platinum-based chemoradiotherapy (CRT) is a global standard of care for patients with unresectable, stage III non-small-cell lung cancer (NSCLC). An earlier analysis from the ongoing PACIFIC-R study (NCT03798535) demonstrated the effectiveness of this regimen in terms of progression-free survival (PFS). Here, we report the first planned overall survival (OS) analysis.
PATIENTS AND METHODS METHODS
PACIFIC-R is an observational/non-interventional, retrospective study of patients with unresectable, stage III NSCLC who started durvalumab (10 mg/kg intravenously every 2 weeks) within an AstraZeneca-initiated early access program between September 2017 and December 2018. Primary endpoints are OS and investigator-assessed PFS, estimated using the Kaplan-Meier method.
RESULTS RESULTS
By 30 November 2021, the full analysis set included 1154 participants from 10 countries (median follow-up in censored patients: 38.7 months). Median OS was not reached, and the 3-year OS rate was 63.2% (95% confidence interval 60.3% to 65.9%). Three-year OS rates were numerically higher among patients with programmed death-ligand 1 (PD-L1) expression on ≥1% versus <1% of tumor cells (TCs; 67.0% versus 54.4%) and patients who received concurrent CRT (cCRT) versus sequential CRT (sCRT) (64.8% versus 57.9%).
CONCLUSIONS CONCLUSIONS
PACIFIC-R data continue to provide evidence for the effectiveness of consolidation durvalumab after CRT in a large, diverse, real-world population. Better outcomes were observed among patients with PD-L1 TCs ≥1% and patients who received cCRT. Nevertheless, encouraging outcomes were still observed among patients with TCs <1% and patients who received sCRT, supporting use of consolidation durvalumab in a broad population of patients with unresectable, stage III NSCLC.

Identifiants

pubmed: 38833971
pii: S2059-7029(24)01233-X
doi: 10.1016/j.esmoop.2024.103464
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103464

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

A R Filippi (AR)

Radiation Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo and University of Pavia, Pavia, Italy. Electronic address: andreariccardo.filippi@istitutotumori.mi.it.

J Bar (J)

Institute of Oncology, Sheba Medical Centre, Ramat Gan; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

C Chouaid (C)

Service de Pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France.

D C Christoph (DC)

Department of Medical Oncology, Evang. Kliniken Essen-Mitte, Evang. Huyssens-Stiftung Essen-Huttrop, Essen, Germany.

J K Field (JK)

Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.

R Fietkau (R)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany.

M C Garassino (MC)

Department of Hematology/Oncology, The University of Chicago, Chicago, USA.

P Garrido (P)

Medical Oncology Department, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.

V D Haakensen (VD)

Department of Oncology and Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.

S Kao (S)

Chris O'Brien Lifehouse, Sydney.

B Markman (B)

Cabrini Hospital and Monash University, Melbourne, Australia.

F McDonald (F)

Lung Unit, The Royal Marsden NHS Foundation Trust, London, UK.

F Mornex (F)

Department of Radiation Oncology, Centre Hospitalier Universitaire de Lyon, Lyon, France.

M Moskovitz (M)

Rambam Health Care Campus, Haifa, Israel.

S Peters (S)

Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

A Sibille (A)

Department of Pneumology, Centre Hospitalier Universitaire de Liège, Liège, Belgium.

S Siva (S)

Peter MacCallum Cancer Centre and The University of Melbourne, Melbourne, Australia.

M van den Heuvel (M)

Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.

P Vercauter (P)

Department of Pneumology, OLV Hospital Aalst, Aalst, Belgium.

S Anand (S)

AstraZeneca, Gaithersburg, USA.

P Chander (P)

AstraZeneca, Gaithersburg, USA.

M Licour (M)

AstraZeneca, Courbevoie, France.

A R de Lima (AR)

AstraZeneca, Gaithersburg, USA.

Y Qiao (Y)

AstraZeneca, Gaithersburg, USA.

N Girard (N)

Institut du Thorax Curie Montsouris, Institut Curie, Paris; UVSQ, Paris Saclay, Versailles, France.

Classifications MeSH