Real-world outcomes with durvalumab after chemoradiotherapy in patients with unresectable stage III NSCLC: interim analysis of overall survival from PACIFIC-R

A. R. Filippi*, J. Bar, C. Chouaid, D. C. Christoph, J. K. Field, R. Fietkau, M. C. Garassino, P. Garrido, V. D. Haakensen, S. Kao, B. Markman, F. McDonald, F. Mornex, M. Moskovitz, S. Peters, A. Sibille, S. Siva, M. van den Heuvel, P. Vercauter, S. AnandP. Chander, M. Licour, A. R. de Lima, Y. Qiao, N. Girard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Based on the findings of the PACIFIC trial, consolidation durvalumab following platinum-based chemoradiotherapy (CRT) is a global standard of care for patients with unresectable, stage III non-small-cell lung cancer (NSCLC). An earlier analysis from the ongoing PACIFIC-R study (NCT03798535) demonstrated the effectiveness of this regimen in terms of progression-free survival (PFS). Here, we report the first planned overall survival (OS) analysis. Patients and methods: PACIFIC-R is an observational/non-interventional, retrospective study of patients with unresectable, stage III NSCLC who started durvalumab (10 mg/kg intravenously every 2 weeks) within an AstraZeneca-initiated early access program between September 2017 and December 2018. Primary endpoints are OS and investigator-assessed PFS, estimated using the Kaplan–Meier method. Results: By 30 November 2021, the full analysis set included 1154 participants from 10 countries (median follow-up in censored patients: 38.7 months). Median OS was not reached, and the 3-year OS rate was 63.2% (95% confidence interval 60.3% to 65.9%). Three-year OS rates were numerically higher among patients with programmed death-ligand 1 (PD-L1) expression on ≥1% versus <1% of tumor cells (TCs; 67.0% versus 54.4%) and patients who received concurrent CRT (cCRT) versus sequential CRT (sCRT) (64.8% versus 57.9%). Conclusions: PACIFIC-R data continue to provide evidence for the effectiveness of consolidation durvalumab after CRT in a large, diverse, real-world population. Better outcomes were observed among patients with PD-L1 TCs ≥1% and patients who received cCRT. Nevertheless, encouraging outcomes were still observed among patients with TCs <1% and patients who received sCRT, supporting use of consolidation durvalumab in a broad population of patients with unresectable, stage III NSCLC.

Original languageEnglish
Article number103464
JournalESMO Open
Volume9
Issue number6
DOIs
StatePublished - Jun 2024

Funding

FundersFunder number
AstraZeneca

    Keywords

    • durvalumab
    • immunotherapy
    • locally advanced NSCLC
    • PD-L1
    • real-world evidence

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