Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer
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 perfor...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.13426 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Chia‐Hsun Chu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T17:46:01Z |
| format | Article |
| id | doaj.art-521f162d13944edf8763192c7fba81bd |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-04-13T17:46:01Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-521f162d13944edf8763192c7fba81bd2022-12-22T02:36:57ZengWileyThoracic Cancer1759-77061759-77142020-06-011161541154910.1111/1759-7714.13426Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancerChia‐Hsun Chu0Tzu‐Hsuan Chiu1Chin‐Chou Wang2Wen‐Chen Chang3Allen Chung‐Cheng Huang4Chien‐Ying Liu5Chih‐Liang Wang6Ho‐Wen Ko7Fu‐Tsai Chung8Ping‐Chih Hsu9Yi‐Ke Guo10Chih‐Hsi S. Kuo11Cheng‐Ta Yang12Division of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Pulmonary & Critical Care Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung TaiwanThoracic Oncology Unit Chang Gung Memorial Hospital Cancer Center Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanData Science Institute, Department of Computing Imperial College London London UKDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanDivision of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital, Chang Gung University, College of Medicine Taoyuan City TaiwanBackground 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.https://doi.org/10.1111/1759-7714.13426Chemoradiationconsolidationdurvalumab |
| spellingShingle | 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 Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer Thoracic Cancer Chemoradiation consolidation durvalumab |
| title | Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer |
| title_full | Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer |
| title_fullStr | Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer |
| title_full_unstemmed | Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer |
| title_short | Consolidation treatment of durvalumab after chemoradiation in real‐world patients with stage III unresectable non‐small cell lung cancer |
| title_sort | consolidation treatment of durvalumab after chemoradiation in real world patients with stage iii unresectable non small cell lung cancer |
| topic | Chemoradiation consolidation durvalumab |
| url | https://doi.org/10.1111/1759-7714.13426 |
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