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. 2026 Feb 16:47:101143.
doi: 10.1016/j.ctarc.2026.101143. Online ahead of print.

Real-life management of stage III non-small cell lung cancer patients in Italy: the BE-PACIFIC observational study

Paolo Bironzo  1 , Alessandro Morabito  2 , Sonia Silipigni  3 , Vincenzo Adamo  4 , Enrica Capelletto  5 , Sabrina Rossi  6 , Marcello Tiseo  7 , Michele Montrone  8 , Ivan Facilissimo  9 , Gianpiero Romano  10 , Luna Chiara Masini  11 , Giovanni Luca Ceresoli  12 , Cesare Gridelli  13 , Antonio Lugini  14 , Sara Pilotto  15 , Pierosandro Tagliaferri  16 , Emilio Bria  17 , Diego Cortinovis  18 , Erika Rijavec  19 , Paolo Borghetti  20 , Matteo Brighenti  21 , Anna Maria Carta  22 , Libero Ciuffreda  23 , Raffaele Giusti  24 , Marianna Macerelli  25 , Francesco Verderame  26 , Francesca Zanelli  27 , Rossana Berardi  28 , Vanesa Gregorc  29 , Concetta Sergi  30 , Emanuela Vattemi  31 , Roberto Ferrara  32 , Pier Luigi Piovano  33 , Lorenzo Livi  34 , Gloria Borra  35 , Stefania Gori  36 , Michele Aieta  37 , Alessandro Bertolini  38 , Fabiana Letizia Cecere  39 , Giulia Pasello  40 , Danilo Rocco  41 , Giuseppe Lo Certo  42 , Livia Marrone  43 , Lucia Simoni  44 , Barbara Roncari  45 , Silvia Novello  46 , Sara Ramella  47 ; BE-PACIFIC Study Group
Collaborators, Affiliations

Real-life management of stage III non-small cell lung cancer patients in Italy: the BE-PACIFIC observational study

Paolo Bironzo et al. Cancer Treat Res Commun. .

Abstract

Background: Stage III non-small cell lung cancer (NSCLC) includes a heterogeneous group of patients with diverse disease presentation, biological portrait, and prognosis. Optimal management requires tailored approaches and multimodal strategies through a multidisciplinary team (MDT) decision-making process. The BE-PACIFIC study primarily aimed at describing treatment strategies of stage III NSCLC according to the Italian standard clinical practice, diagnostic work-up and survival outcomes during observation.

Patients and methods: The BE-PACIFIC is an observational multicentre retrospective and prospective cohort study, involving both primary data collection and secondary use of data. Adult patients with confirmed diagnosis of stage III NSCLC were included by 40 sites and followed up for 12 months after diagnosis.

Results: From 1st August 2019, to 31st July 2020, 311 subjects were enrolled: 296 (95.2%) were evaluable for the analyses. The median (25th-75th percentiles) duration of the diagnostic process was 30.4 (21.0-60.9) days. MDT was involved in treatment plan definition of 88.7% (n/N=260/293) of patients. Sixty (20.3%) patients had tumour resection, mostly associated with neoadjuvant (n=26, 43.3%) or adjuvant (n=22, 36.7%) treatment alone. Chemoradiation was used in 165 of 236 (69.9%) non-resected patients, followed by durvalumab in 80 cases (48.5%).

Conclusions: MDT was largely involved in stage III NSCLC management, with at least 75% of patients completing the diagnostic process within 2 months. Consolidation durvalumab was used in half of non-resected patients treated with chemoradiation, with favourable retention rates and response, consistently with the PACIFIC trial findings.

Keywords: Italian Real-World Evidence; Lung cancer; PD-L1 test; Stage III NSCLC; durvalumab.

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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. P. Bironzo has received payment or honoraria from AstraZeneca, Bristol Myers Squibb, MSD Oncology, Roche, Takeda, Novartis, Sanofi, Amgen, Daiichi Sankyo/Arqule, has received institutional research grants from Roche and Pfizer, and has had Consulting or Advisory Role for Roche, Janssen Oncology, Pierre Fabre, Amgen, Seagen, Regeneron A. Morabito received speakers’ and consultants’ fee from AstraZeneca, Pfizer, Eli-Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Takeda, Pierre Fabre, Amgen, Sanofi, Janssen. S. Silipigni declares no conflict of interest. V. Adamo declares no conflict of interest. E. Capelletto declares no conflict of interest. S. Rossi declares no conflict of interest. M. Tiseo received speakers’ and consultants’ fee from AstraZeneca, Pfizer, Eli-Lilly, BMS, Novartis, Roche, MSD, Boehringer Ingelheim, Takeda, Amgen, Merck, Sanofi, Janssen, Daiichi Sankyo. He received institutional research grants from AstraZeneca, Boehringer Ingelheim and Roche; and travel support from Amgen and Takeda. M. Montrone declares no conflict of interest. I. Facilissimo declares no conflict of interest. Gianpiero Romano declares no conflict of interest. L.C. Masini declares no conflict of interest. G.L. Ceresoli received fees for speaker engagements from Bristol Myers Squibb, Merck Sharp & Dohme, Novocure, AstraZeneca, Bayer, and Astellas; and fees for advisory roles from Bristol Myers Squibb, Novocure, and AstraZeneca. C. Gridelli received honoraria as speaker bureau and advisory board member from AstraZeneca, BMS, MSD and Roche. A. Lugini declares no conflict of interest. S. Pilotto declares no conflict of interest. P. Tagliaferri declares no conflict of interest. E. Bria has received grants or contracts from Astra-Zeneca, Roche and honoraria for lectures from Merck-Sharp & Dome, Astra-Zeneca, Pfizer, Eli-Lilly, Bristol-Myers Squibb, Novartis, Takeda and Roche, and has been member of Data Safety Monitoring Board or Advisory Board of Merck-Sharp & Dome, Pfizer, Novartis, Bristol-Myers Squibb, Astra-Zeneca, and Roche. D. Cortinovis declares no conflict of interest. E. Rijavec received honoraria from Bristol-Myers Squibb, AstraZeneca MSD, and Roche; advisory board fees from Sanofi; travel grants from Daichii Sankyo. P. Borghetti received honoraria from AstraZeneca, Roche. M. Brighenti declares no conflict of interest. A.M. Carta declares no conflict of interest. L. Ciuffreda declares no conflict of interest. R. Giusti declares no conflict of interest. M. Macerelli declares no conflict of interest. F. Verderame declares no conflict of interest. F. Zanelli declares no conflict of interest. R. Berardi has received fees for acting as a consultant, for lectures and/or for participating to advisory board from BI, EISAI, GSK, Italfarmaco, Otsuka, Lilly, MSD, and has received funding to Institution from AstraZeneca, BMS, Pfizer, Novartis, Roche; AMGEN. V. Gregorc declares no conflict of interest. C. Sergi declares no conflict of interest. E. Vattemi declares no conflict of interest. R. Ferrara declares no conflict of interest. P.L. Piovano declares no conflict of interest. L. Livi declares no conflict of interest. G. Borra declares no conflict of interest. S. Gori declares no conflict of interest. M. Aieta declares no conflict of interest. A. Bertolini declares no conflict of interest. F.L. Cecere declares no conflict of interest. G. Pasello declares no conflict of interest. D. Rocco declares no conflict of interest. G. Lo Certo is an employee of AstraZeneca, Italy. L. Marrone is an employee of AstraZeneca, Italy. L. Simoni is an employee of IQVIA Solutions Italy SRL. B. Roncari is an employee of IQVIA Solutions Italy SRL. S. Novello declares receiving honoraria for lectures, presentations, speakers' bureaus, or educational events from AstraZeneca, Amgen, BeiGene, Pfizer, MSD, Sanofi, Takeda, Thermo Fisher, Janssen, Novartis, and Roche; and participating on a data safety monitoring board or advisory board from AstraZeneca, Amgen, BeiGene, Pfizer, MSD, Sanofi, Takeda, Janssen, and Roche. S. Ramella declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from MSD Italia, Genetec, and Istituto Gentili Amgen; and participation on a data safety monitoring board or advisory board for AstraZeneca and Roche.

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