Treatment Characteristics and Real-World Progression-Free Survival in Patients With Unresectable Stage III NSCLC Who Received Durvalumab After Chemoradiotherapy: Findings From the PACIFIC-R Study |
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| Affiliation: | 1. Institut du Thorax Curie Montsouris, Institut Curie, Paris, France and UVSQ, Paris Saclay, Versailles, France;2. Institute of Oncology, Sheba Medical Centre, Ramat Gan, Israel;3. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;4. Medical Oncology Department, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain;5. Department of Hematology/Oncology, The University of Chicago, Chicago, Illinois;6. Lung Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom;7. Department of Radiation Oncology, Centre Hospitalier Universitaire de Lyon, Lyon, France;8. Radiation Oncology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo and University of Pavia, Pavia, Italy;9. Department of Pulmonary Diseases, Rijnstate Hospital, Arnhem, The Netherlands;10. Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland;11. Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom;12. Department of Medical Oncology/Hematology, Evang. Kliniken Essen-Mitte, Evang. Huyssens-Stiftung Essen-Huttrop, Essen, Germany;13. Department of Pneumology and Allergology, Centre Hospitalier Universitaire de Liège, Liège, Belgium;14. Department of Radiation Oncology, Universitätsklinikums Erlangen, Erlangen, Germany;15. Department of Oncology and Institute for Cancer Research, Oslo University Hospital, Oslo, Norway;p. Service de Pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France;q. Cabrini Hospital and Monash University, Melbourne, Victoria, Australia;r. University of Groningen, Department of Pulmonary Diseases, University Medical Center Groningen, Groningen, The Netherlands;s. Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain;t. AstraZeneca, Cambridge, United Kingdom;u. AstraZeneca, Gaithersburg, Maryland;v. AstraZeneca, Courbevoie, France;w. Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Victoria, Australia |
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| Abstract: | IntroductionThe phase 3 PACIFIC trial established consolidation therapy with durvalumab as standard of care for patients with unresectable, stage III NSCLC and no disease progression after definitive chemoradiotherapy (CRT). The observational PACIFIC-R study assesses the real-world effectiveness of durvalumab in patients from an early access program. Here, we report treatment characteristics and a preplanned analysis of real-world progression-free survival (rwPFS).MethodsPACIFIC-R (NCT03798535) is an ongoing, international, retrospective study of patients who started durvalumab (intravenously; 10 mg/kg every 2 wk) within an early access program between September 2017 and December 2018. The primary end points are investigator-assessed rwPFS and overall survival (analyzed by Kaplan–Meier method).ResultsAs of November 30, 2020, the full analysis set comprised 1399 patients from 11 countries (median follow-up duration, 23.5 mo). Patients received durvalumab for a median of 11.0 months. Median rwPFS was 21.7 months (95% confidence interval: 19.1–24.5). RwPFS was numerically longer among patients who received concurrent versus sequential CRT (median, 23.7 versus 19.3 mo) and among patients with programmed cell death-ligand 1 expression greater than or equal to 1% versus less than 1% (22.4 versus 15.6 mo). Overall, 16.5% of the patients had adverse events leading to treatment discontinuation; 9.5% of all patients discontinued because of pneumonitis or interstitial lung disease.ConclusionsConsolidation durvalumab after definitive CRT was well tolerated and effective in this large, real-world cohort study of patients with unresectable, stage III NSCLC. As expected, rwPFS was longer among patients who received concurrent versus sequential CRT and patients with higher programmed cell death-ligand 1 expression. Nevertheless, favorable rwPFS outcomes were observed regardless of these factors. |
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| Keywords: | Consolidation therapy Immunotherapy Locally advanced NSCLC PD-L1 inhibition Real-world data |
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