Durvalumab in locally advanced unresectable non-small cell lung cancer - Benchmarking real-world outcomes in England against published trial data

Abstract

Background: Durvalumab after chemoradiotherapy (CRT) is indicated for the treatment of locally advanced, unresectable non-small cell lung cancer based on the PACIFIC trial data. The National Institute for Health and Care Excellence recommended reimbursement via the Cancer Drugs Fund (CDF). Using the NHS England Systemic Anti-Cancer Therapy (SACT) dataset, we compared real-world outcomes against those of the PACIFIC trial.

Methods: Patients with a CDF application for durvalumab between 28 March 2019 and 1 February 2021 were identified from the NHS England Blueteq system and linked to SACT. Primary endpoints were overall survival (OS) and Time to First Subsequent Therapy (TFST). Comparisons between baseline characteristics including gender, age, performance status, stage of disease, histological subtype and PD-L1 expression were estimated using the log rank test.

Results: 591 patients were included in this analysis (compared with PACIFIC n = 476). Median age was 67 years (PACIFIC 64y), 59 % were male (PACIFIC 70 %). Median OS was 50 months (PACIFIC 48 months). Median TFST was 38 months (PACIFIC 22 months).

Conclusion: Outcomes are comparable to the PACIFIC trial suggesting the trial data are generalisable to the real-world setting. This study demonstrates how population-based data can provide continued evaluation of clinical outcomes in routine care.