Real-World Clinical Outcomes and Treatment Patterns in Patients with Unresectable Stage III NSCLC Treated with CCRT With or Without Durvalumab as Consolidation Therapy: A Retrospective Cohort Study

Background: Durvalumab is currently approved as consolidation therapy for patients with unresectable stage III non-small cell lung cancer (NSCLC) without disease progression following concurrent chemoradiotherapy (cCRT). This study described real-world characteristics, disease progression, subsequent treatment, and clinical outcomes according to durvalumab receipt. Methods: This retrospective cohort study used the N-Power Medicine database. Adults diagnosed with unresectable stage III NSCLC who initiated cCRT between February 2018 and October 2023 and subsequently received durvalumab or no durvalumab and were followed until October 2025. Baseline characteristics, disease progression, and subsequent treatment patterns were summarized descriptively. Kaplan–Meier methods were used to estimate overall survival (OS) and time to death or distant metastasis (TDDM). Results: Among 717 patients who initiated cCRT, 487 received cCRT followed by durvalumab and 230 received cCRT only. Baseline characteristics were broadly similar between cohorts. Median theoretical follow-up was 60.5 and 60.8 months, respectively. Disease progression was observed in both groups, with higher rates in the cCRT-only cohort (48.7% vs. 40.9%). TDDM was 26.7 months in the cCRT + durvalumab cohort and 5.6 months in the cCRT-only cohort. Median OS was 42.6 months and 11.4 months, and OS events occurred in 55.2% and 80.0% of patients, respectively. In the cCRT + durvalumab cohort, OS rates at 12, 36 and 60 months were 83.6%, 56.0%, and 42.8%. Conclusions: In real-world practice, approximately one-third of patients with unresectable stage III NSCLC did not receive durvalumab following cCRT. Despite consolidation therapy, a substantial proportion of patients continue to experience disease progression, highlighting ongoing unmet need in this population.