Please use this identifier to cite or link to this item: https://doi.org/10.1111/1759-7714.14667
Title: Real-world experience of consolidation durvalumab after concurrent chemoradiotherapy in stage III non-small cell lung cancer
Authors: Huang, Yiqing
Zhao, Joseph J
Soon, Yu Yang 
Wong, Alvin
Aminkeng, Folefac 
Ang, Yvonne
Asokumaran, Yugarajah
Low, Jia Li
Lee, Matilda
Choo, Joan RE
Chan, Gloria
Kee, Adrian 
Tay, Sen Hee 
Goh, Boon Cher 
Soo, Ross A 
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Respiratory System
consolidation
Durvalumab
non-small cell lung cancer
real-world
stage III
TO-LYMPHOCYTE RATIO
EGFR MUTATION
CLINICAL-OUTCOMES
SUBGROUP ANALYSIS
NSCLC
ONCOLOGY
CHEMORADIATION
RADIOTHERAPY
HALLMARKS
PATTERNS
Issue Date: 30-Sep-2022
Publisher: WILEY
Citation: Huang, Yiqing, Zhao, Joseph J, Soon, Yu Yang, Wong, Alvin, Aminkeng, Folefac, Ang, Yvonne, Asokumaran, Yugarajah, Low, Jia Li, Lee, Matilda, Choo, Joan RE, Chan, Gloria, Kee, Adrian, Tay, Sen Hee, Goh, Boon Cher, Soo, Ross A (2022-09-30). Real-world experience of consolidation durvalumab after concurrent chemoradiotherapy in stage III non-small cell lung cancer. THORACIC CANCER 13 (22) : 3152-3161. ScholarBank@NUS Repository. https://doi.org/10.1111/1759-7714.14667
Abstract: Background: Durvalumab consolidation is associated with improved survival following concurrent chemoradiotherapy (CCRT) in patients with stage III non-small cell lung cancer (NSCLC). Given the heterogeneity of stage III NSCLC patients, in this study we evaluated the efficacy and safety of durvalumab in the real-world setting. Method: Unresectable stage III NSCLC patients were retrospectively studied: one cohort received CCRT, another had CCRT-durvalumab. Primary endpoints were progression-free survival (PFS) and overall survival (OS), secondary endpoints were relapse rate and safety. In CCRT-durvalumab cohort, association between blood markers with survival and pneumonitis risk were analyzed. Results: A total of 84 patients were enrolled: 45 received CCRT, and 39 received CCRT-durvalumab. Median PFS was 17.5 months for CCRT-durvalumab and 8.9 months for CCRT-alone (HR 0.47, p = 0.038). Median OS was not-reached for CCRT-durvalumab and 22.3 months for CCRT-alone (HR 0.35, p = 0.024). Both EGFR-positive and wild-type (WT) patients had numerically improved PFS with durvalumab consolidation compared to CCRT-alone, 17.5 versus 10.9 months and 11.8 versus 6.63 months, respectively (interaction p-value = 0.608). Grade 2+ pneumonitis was detected in 25% of patients in the durvalumab cohort. Most pneumonitis occurred at 3.5 weeks after durvalumab initiation. Baseline neutrophil-to-lymphocyte ratio (NLR) ≥ 3 and ≥5 were associated with shorter PFS with durvalumab. Week 6 platelet-lymphocyte-ratio ≥ 180 was associated with a lower risk of pneumonitis. Conclusion: In this real-world study, durvalumab consolidation post CCRT was associated with a statistically significant improvement in PFS and OS. Effect of durvalumab on PFS was not modified by EGFR status. Active surveillance for pneumonitis is crucial. Baseline NLR may help to predict the benefit of treatment with durvalumab.
Source Title: THORACIC CANCER
URI: https://scholarbank.nus.edu.sg/handle/10635/235035
ISSN: 1759-7706
1759-7714
DOI: 10.1111/1759-7714.14667
Appears in Collections:Staff Publications
Elements

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
Real‐world_experience_of_conso.pdf865.87 kBAdobe PDF

OPEN

PublishedView/Download

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.