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Observational Study
. 2025:43:100929.
doi: 10.1016/j.ctarc.2025.100929. Epub 2025 Apr 19.

Durvalumab consolidation after chemoradiotherapy in unresectable stage III non-small cell lung cancer: A real-world experience from the Australian subset of PACIFIC-R

Ben Markman  1 , Steven Kao  2 , Nick Pavlakis  3 , Victoria Bray  4 , Leisl Packer  5 , Shankar Siva  6
Affiliations
Free article
Observational Study

Durvalumab consolidation after chemoradiotherapy in unresectable stage III non-small cell lung cancer: A real-world experience from the Australian subset of PACIFIC-R

Ben Markman et al. Cancer Treat Res Commun. 2025.
Free article

Abstract

Microabstract: Australian subset of the multicentric PACIFIC-R study (NCT03798535) in patients with unresectable, stage III non-small cell lung cancer without progression following chemoradiotherapy, found a median progression-free survival of 22.4 months (95% confidence interval, 17.5 to 30.8) confirming clinical benefit of durvalumab consolidation post-chemoradiotherapy in the real-world setting.

Introduction: The Phase 3 PACIFIC trial established post-chemoradiotherapy (CRT) durvalumab consolidation as standard treatment for patients with unresectable, stage III non-small cell lung cancer (NSCLC). We present the results from the Australian subset of the multicentric PACIFIC-R study (NCT03798535) assessing the effectiveness of durvalumab in the real-world setting.

Patients and methods: Patients with unresectable, stage III NSCLC without progression following CRT, receiving at least 1 dose of durvalumab (10 mg/kg intravenously, every 2 weeks) through an early access program (EAP) between September 2017 and December 2019, were enrolled. Primary endpoints, progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier method.

Results: AS OF FEBRUARY 7, 2022, 165 PATIENTS (MEDIAN AGE: 67.0 years) with a median follow-up of 34.7 months were enrolled. Most received last radiation ≥42 days before durvalumab initiation (126, 79.2%) at a dose of 54 to 60 Gy (141, 88.7%). Median PFS was 22.4 months (95% confidence interval [CI], 17.5 to 30.8). The 3-year PFS and OS rates were 38.9% (95% CI, 31.0 to 46.7) and 59.1% (95% CI, 51.2 to 66.2). Pneumonitis was the most frequent adverse events of special interest (27, 16.4%); which led to treatment discontinuation in 19 (11.5%) patients.

Conclusion: The real-world results from the Australian PACIFIC-R subset confirm translation of the clinical benefit of post-CRT durvalumab consolidation in the pivotal PACIFIC trial to the real-world setting, showing favorable survival outcomes, irrespective of delays in durvalumab initiation post-radiation.

Keywords: Australia; Durvalumab; PACIFIC-R; Progression-free survival; Unresectable stage III NSCLC.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ben Markman reports consulting fee from Bristol Myers Squibb (BMS) and participation on advisory boards from Amgen, MSD, Beigene, and AstraZeneca. Shankar Siva reports receiving research support from Varian medical Systems, Bayer Pharmaceuticals, and Merck Sharp Dohme (MSD); reports honoraria from AstraZeneca, Varian Medical Systems, Roche Pharmaceuticals, and Telix Pharmaceuticals; reports leadership role with American Society of Radiation Oncology (ASTRO) Science Council member (2019 to present), Advanced Radiotherapy Techniques (ART) committee of the International Association for the Study of Lung Cancer (IASLC) (2019 to present), Board of Directors of the Radiosurgery Society (RSS) (April 1, 2020 through March 31, 2023). Nick Pavlakis reports receiving grant from Bayer Pharmaceuticals, Pfizer, and Roche; consulting fee from MSD, Merck, BMS, AstraZeneca, Takeda, Pfizer, Roche, Amgen, Beigene, and Gilead; payments or honoraria from Merck, Pfizer, Roche, Takeda, Pierre-Faber, Illumina, Bayer Pharmaceuticals; served as Board Chair for the Thoracic Oncology Group of Australasia (unpaid, voluntary role). Steven Kao reports receiving grants from AstraZeneca; honoraria for MSD, BMS, Roche, AstraZeneca, Pfizer, Takeda, and Beigene; support for attending meeting from MSD; participation on data safety monitoring or advisory boards from AstraZeneca, Pfizer, MSD, BMS, Roche, Amgen, Beigene, and Boehringer. Leisl Packer and Victoria Bray declared no conflicts of interest.

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