Durvalumab after Chemoradiotherapy for the Treatment of Patients with Stage III Non-Small Cell Lung Cancer: A Lebanese Real-World Study
Nabih Naim, Roland Eid, Sara Moukheiber, Rebecca Khoueiry, Colette Hanna, Adel Tabchy, Alain Daher, Marwan Ghosn, Ahmad Younes, Fadi El Karak, Georges Chahine, Hampig Raphael KourieAbstract
Background:
Based on the PACIFIC trial, durvalumab has been approved since 2018 as consolidation therapy for patients with unresectable stage III non-small cell lung cancer who have not progressed after chemoradiotherapy. Patients seen in everyday practice, however, are more heterogeneous than trial populations.
Objectives:
To assess the real-world use, effectiveness, and safety of durvalumab in patients with unresectable stage III non-small cell lung cancer in Lebanon.
Materials and Methods:
This phase IV, retrospective, multicenter study analyzed patient characteristics, progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs). Cox regression was used to assess the impact of age, sex, disease stage, histological subtype, programmed death ligand 1 (PD-L1) expression, type of prior chemoradiotherapy, and interval between chemoradiotherapy completion and durvalumab initiation on PFS.
Results:
Twenty-five patients were included, most with squamous histology (64%) and stage IIIB disease (92%). Twenty-three patients (92%) received prior concurrent chemoradiotherapy and two (8%) sequential chemoradiotherapy. PD-L1 expression was ≥1% in 40% of patients and <1% in 24%. Six patients (24%) experienced disease progression. Median PFS was 27.0 months (95% CI: 8.32–45.68), with PFS rates of 75.8% at 12 months and 66.3% at 24 months. The OS was 100% at 12 months and 87.5% at 24 months. None of the evaluated clinicopathological factors significantly influenced PFS. Four patients (16%) discontinued durvalumab because of AEs (grade 3 pneumonitis, psoriatic arthritis, grade 3 hepatotoxicity, and allergy). One patient with an adrenal oligometastasis underwent adrenalectomy and successfully resumed durvalumab.
Conclusion:
Our findings are consistent with those of the PACIFIC trial and other real-world studies, supporting the effectiveness and tolerability of consolidation durvalumab in clinical practice.