Prospective multicenter cohort study of durvalumab for patients with unresectable stage III non-small cell lung cancer and grade 1 radiation pneumonitis
Menée auprès de 35 patients atteints d'un cancer du poumon non à petites cellules de stade III non résécable et présentant une pneumopathie induite par les rayonnements, cette étude de cohorte prospective multicentrique évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité du durvalumab après une chimioradiothérapie
Objective : Durvalumab was safe and effective in patients with unresectable stage III non-small cell lung cancer (NSCLC) after concurrent chemoradiotherapy (CCRT) in a phase 3 trial (PACIFIC trial). Although a history of radiation pneumonitis (RP) has been reported to increase the risk of exacerbation of pneumonitis associated with programmed death-1 axis inhibitors, the detailed clinical results of durvalumab treatment in patients with baseline grade 1 RP were not reported in the PACIFIC trial. Therefore, we aimed to evaluate the safety and effectiveness of durvalumab therapy in these patients. Materials and Methods : This was a multicenter prospective cohort study involving 35 patients. Patients were eligible if they met the following criteria: inoperable stage III NSCLC, administration of durvalumab within 42 days after CCRT using platinum-based chemotherapy, no disease progression after CCRT, Eastern Cooperative Oncology Group performance status of 0–1, and presence of grade 1 RP at baseline. We assessed the effectiveness and safety of durvalumab with a minimum 1-year follow-up period for all patients. Results : Thirty-five patients were enrolled in our study from February 2019 to December 2019. The median progression-free survival was 11.4 months (95% confidence interval, 7.1 months–not reached), and the median overall survival was not reached. Eleven (31%) patients had grade
≥
2 pneumonitis/RP, 10 (28%) developed grade 2 pneumonitis/RP, and 1 (3%) developed grade 5 pneumonitis/RP. Five (14%) patients experienced treatment-related grade
≥
3 adverse events. Conclusion : Durvalumab might be safe and effective in patients with stage III NSCLC with baseline grade 1 RP following chemoradiotherapy.