Consolidation treatment of durvalumab after chemoradiation in real-world patients with stage III unresectable non-small cell lung cancer

Chia Hsun Chu*, Tzu Hsuan Chiu, Chin Chou Wang, Wen Chen Chang, Allen Chung Cheng Huang, Chien Ying Liu, Chih Liang Wang, Ho Wen Ko, Fu Tsai Chung, Ping Chih Hsu, Yi-Ke Guo, Chih Hsi S. Kuo*, Cheng Ta Yang

*Corresponding author for this work

    Research output: Contribution to journalJournal articlepeer-review

    29 Citations (Scopus)

    Abstract

    Background: Treatment for stage III non-small cell lung cancer (NSCLC) of unresectable disease mainly involves concurrent chemoradiation (CRT). Post-CRT consolidation treatment with durvalumab is a major therapeutic advance that provides survival benefit in this group of patients. However, the performance of this treatment strategy remains to be studied in a real-world setting. Methods: A total of 31 patients who had disease control post-CRT were included in the durvalumab early access program (EAP) as an intent-to-treat cohort and retrospectively reviewed for post-CRT progression-free survival (PFS) and time to metastatic disease or death (TMDD). The neutrophil-to-lymphocyte ratio (NLR) at the initiation of durvalumab was analyzed in 29 patients. Results: The median time from the completion of concurrent CRT to the initiation of durvalumb was 2.8 months. The objective response was 25.8% and the 12 month PFS and TMDD-free rate were 56.4% and 66.9%, respectively. The low NLR patients showed a significantly longer post-CRT PFS (not reach vs. 12.0 months [95% CI: 5.5–not estimable]; P = 0.040; the hazard ratio for disease progression or death, 0.23 [95% CI: 0.05–1.00]; P = 0.048) and the 12 month post-CRT PFS rate (82.5 vs. 42.6%). The post-CRT TMDD (not reach vs. 12.6 months, [95% CI: 10.8–not estimable]; P = 0.010; the hazard ratio for distant metastasis or death, 0.11 [95% CI: 0.01–0.88]; P = 0.037) and 12 month post-CRT TMDD-free rate (90.9 vs. 57.1%) were also significantly higher in the low NLR patients. Conclusions: Durvalumab consolidation treatment in real-world patients showed substantial efficacy and the correlation with the NLR level warrants further investigation.

    Original languageEnglish
    Pages (from-to)1541-1549
    Number of pages9
    JournalThoracic Cancer
    Volume11
    Issue number6
    DOIs
    Publication statusPublished - 1 Jun 2020

    Scopus Subject Areas

    • Oncology
    • Pulmonary and Respiratory Medicine

    User-Defined Keywords

    • Chemoradiation
    • consolidation
    • durvalumab

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