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. 2022 Apr 1;45(4):142-145.
doi: 10.1097/COC.0000000000000899.

Uptake of Adjuvant Durvalumab After Definitive Concurrent Chemoradiotherapy for Stage III Nonsmall-cell Lung Cancer

Alex K Bryant  1 , Huiying Yin  2 , Matthew J Schipper  1   2 , Peter A Paximadis  3 , Thomas P Boike  4 , Derek P Bergsma  5 , Benjamin Movsas  6 , Robert T Dess  1 , Melissa A Mietzel  1 , Randi Kendrick  1 , Merita Seferi  1 , Michael M Dominello  7 , Martha M Matuszak  1 , Reshma Jagsi  1 , James A Hayman  1 , Lori J Pierce  1 , Shruti Jolly  1 ; Michigan Radiation Oncology Quality Consortium
Affiliations

Uptake of Adjuvant Durvalumab After Definitive Concurrent Chemoradiotherapy for Stage III Nonsmall-cell Lung Cancer

Alex K Bryant et al. Am J Clin Oncol. .

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

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