A Real-World, Multicenter, Observational Retrospective Study of Durvalumab After Concomitant or Sequential Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer

Alessio Bruni, Vieri Scotti, Paolo Borghetti, Stefano Vagge, Salvatore Cozzi, Elisa D'Angelo, Niccolò Giaj Levra, Alessandra Fozza, Maria Taraborrelli, Gaia Piperno, Valentina Vanoni, Matteo Sepulcri, Marco Trovò, Valerio Nardone, Elisabetta Lattanzi, Said Bou Selman, Federica Bertolini, Davide Franceschini, Francesco Agustoni, Barbara Alicja Jereczek-FossaStefano Maria Magrini, Lorenzo Livi, Frank Lohr, Andrea Riccardo Filippi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: For unresectable stage III non-small cell lung cancer (NSCLC), the standard therapy consists of chemoradiotherapy (CRT) followed by durvalumab maintenance for responding patients. The present study reports on the safety and outcome of durvalumab use after CRT in a real-world, multicenter, retrospective cohort.

Methods: Two hundred thirty-eight patients have been included. We collected data on systemic therapy, radiation therapy, the timing between CRT and durvalumab, number of durvalumab cycles, reasons for non-starting or discontinuation, incidence and grade of adverse events (AEs), and progression-free survival (PFS) and overall survival (OS).

Results: One hundred fifty-five patients out of 238 (65.1%) received at least one durvalumab dose: 91 (58.7%) after concomitant CRT (cCRT) and 64 (41.3%) after sequential CRT (sCRT). Programmed-death ligand 1 (PD-L1) status was unknown in 7/155 (4.5%), negative in 14 (9.1%), and positive ≥1% in 134/155 (86.4%). The main reasons for non-starting durvalumab were progression (10.1%), PD-L1 negativity (7.5%), and lung toxicity (4.6%). Median follow-up time was 14 months (range 2-29); 1-year PFS and OS were 83.5% (95%CI: 77.6-89.7) and 97.2% (95%CI: 94.6-99.9), respectively. No significant differences in PFS or OS were detected for cCRT vs. sCRT, but the median PFS was 13.5 months for sCRT vs. 23 months for cCRT. Potentially immune-related AEs were recorded in 76/155 patients (49.0%). Pneumonitis was the most frequent, leading to discontinuation in 11/155 patients (7.1%).

Conclusions: Durvalumab maintenenace after concurrent or sequential chemoradiation for unresectable, stage III NSCLC showed very promising short-term survival results in a large, multicenter, restrospective, real-world study. Durvalumab was the first drug obtaining a survival benefit over CRT within the past two decades, and the present study contributes to validating its use in clinical practice.

Original languageEnglish
Pages (from-to)744956
JournalFront. Oncol.
Volume11
DOIs
Publication statusPublished - 2021

Fingerprint

Dive into the research topics of 'A Real-World, Multicenter, Observational Retrospective Study of Durvalumab After Concomitant or Sequential Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer'. Together they form a unique fingerprint.

Cite this