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. 2023 Jul 4:13:1208204.
doi: 10.3389/fonc.2023.1208204. eCollection 2023.

Unresectable stage III non-small cell lung cancer: could durvalumab be safe and effective in real-life clinical scenarios? Results of a single-center experience

Paolo Borghetti  1 , Giulia Volpi  1 , Giorgio Facheris  1 , Gianluca Cossali  1 , Eneida Mataj  1 , Salvatore La Mattina  1 , Navdeep Singh  1 , Jessica Imbrescia  1 , Marco Lorenzo Bonù  1 , Davide Tomasini  1 , Paola Vitali  1 , Diana Greco  1 , Michela Bezzi  2 , Flavia Melotti  3 , Mauro Benvenuti  4 , Andrea Borghesi  5 , Salvatore Grisanti  6 , Michela Buglione di Monale E Bastia  1
Affiliations

Unresectable stage III non-small cell lung cancer: could durvalumab be safe and effective in real-life clinical scenarios? Results of a single-center experience

Paolo Borghetti et al. Front Oncol. .

Abstract

Introduction: The standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by consolidation durvalumab as shown in the PACIFIC trial. The purpose of this study is to evaluate clinical outcomes and toxicities regarding the use of durvalumab in a real clinical scenario.

Methods: A single-center retrospective study was conducted on patients with a diagnosis of unresectable stage III NSCLC who underwent radical CRT followed or not by durvalumab. Tumor response after CRT, pattern of relapse, overall survival (OS) and progression-free survival (PFS), and toxicity profile were investigated.

Results: Eighty-five patients met the inclusion criteria. The median age was 67 years (range 45-82 years). Fifty-two patients (61.2%) started sequential therapy with durvalumab. The main reason for excluding patients from the durvalumab treatment was the expression of PD-L1 < 1%. Only two patients presented a grade 4 or 5 pneumonitis. A median follow-up (FU) of 20 months has been reached. Forty-five patients (52.9%) had disease progression, and 21 (24.7%) had a distant progression. The addition of maintenance immunotherapy confirmed a clinical benefit in terms of OS and PFS. Two-year OS and PFS were respectively 69.4% and 54.4% in the durvalumab group and 47.9% and 24.2% in the no-durvalumab group (p = 0.015, p = 0.007).

Conclusion: In this real-world study, patients treated with CRT plus durvalumab showed clinical outcomes and toxicities similar to the PACIFIC results. Maintenance immunotherapy after CRT has been shown to be safe and has increased the survival of patients in clinical practice.

Keywords: chemo-radiotherapy (CRT); durvalumab; non-small cell lung cancer (NSCLC); real-world data (RWD); stage III.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overall survival curves calculated using the Kaplan–Meier method. CRT, chemoradiotherapy; OS, overall survival.
Figure 2
Figure 2
Progression-free survival curves calculated using the Kaplan–Meier method. CRT, chemoradiotherapy; PFS, progression-free survival.
See this image and copyright information in PMC

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