Outcomes Following Treatment for Progression in Patients Treated With Durvalumab Consolidation in LA-NSCLC.

Autor: Stalker M; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: margaret.stalker@pennmedicine.upenn.edu., Marmarelis M; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Langer C; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Cohen RB; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Singh A; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Aggarwal C; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA., Sun L; Division of Hematology & Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Jazyk: angličtina
Zdroj: Clinical lung cancer [Clin Lung Cancer] 2024 Nov 10. Date of Electronic Publication: 2024 Nov 10.
DOI: 10.1016/j.cllc.2024.11.002
Abstrakt: Introduction: PACIFIC established consolidative durvalumab for LA-NSCLC, but only about half of patients completed a year of therapy. Data on treatment patterns and outcomes after durvalumab are limited.
Methods: Our analysis included patients from a US nationwide database with LA-NSCLC who received consolidative durvalumab between 2017 and 2023 and had subsequent systemic therapy, classified as PD-L1 monotherapy, PD-L1+chemotherapy, chemotherapy alone, PD-L1+CTLA4, or targeted therapy (TT). Time to next treatment (TTNT) was analyzed from durvalumab start and finish to next line of therapy initiation. Overall survival (OS) from start of postdurvalumab therapy was analyzed using Kaplan Meier methodology.
Results: Our cohort included 751 patients, median age 68 (IQR, 61-74), 53% female, 80% White, 91% ECOG 0-1, 90% smoking history, and 53% nonsquamous histology. The most common postdurvalumab treatment was chemotherapy alone in 349 (46%), followed by PD-L1+chemotherapy in 147 (20%), PD-L1 monotherapy in 114 (15%), and TT in 104 (14%). Median duration of durvalumab treatment was 5.5 months (IQR 2.3-10.6); only 9% of patients received a full year of durvalumab, and 64% started next treatment within a year of initiation. Patients treated with chemotherapy-containing regimens had shorter TTNT from durvalumab start/end, as well as shorter median OS [10.8 (5.6-18.8) months for chemotherapy and 12.9 (6.0-24.2) months for chemoimmunotherapy, versus 23.8 (8.7-34.5) months for PD-L1 monotherapy and 30.1 (9.5-NR) months for TT (P < .001)].
Conclusion: Patients treated with systemic therapy after consolidative durvalumab, particularly those requiring chemotherapy-based treatment, have poor outcomes and are in need of improved treatment strategies.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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