Predictors of lung injury during durvalumab maintenance therapy following concurrent chemoradiotherapy in unresectable locally advanced non‐small cell lung carcinoma

Autor: Nobuyuki Hirama, Masaki Yamamoto, Satoshi Nagaoka, Wataru Segawa, Chihiro Sugimoto, Hirokazu Nagayama, Shuntaro Hiro, Yukihito Kajita, Chihiro Maeda, Sousuke Kubo, Kenichi Seki, Yoshinori Nagahara, Shuhei Teranishi, Ken Tashiro, Yu Hara, Nobuaki Kobayashi, Shigenobu Watanabe, Makoto Kudo, Takeshi Kaneko
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Thoracic Cancer, Vol 14, Iss 25, Pp 2601-2607 (2023)
Druh dokumentu: article
ISSN: 1759-7714
1759-7706
DOI: 10.1111/1759-7714.15042
Popis: Abstract Background Based on the results of the PACIFIC trial, maintenance with durvalumab has emerged as the standard treatment following concurrent chemoradiotherapy in patients with unresectable locally advanced non‐small cell lung carcinoma (NSCLC). However, adverse events attributed to durvalumab, especially lung injuries, including immune‐related adverse events, and radiation pneumonitis, are concerning. This study retrospectively investigated the factors related to lung injury in patients receiving the PACIFIC regimen. Methods Patients with unresectable locally advanced NSCLC who received durvalumab maintenance therapy following concurrent chemoradiotherapy at Yokohama City University Medical Centre between July 2018 and March 2022 were included. Clinical data, volume of normal lung receiving 20 or 5 Gy or more (V20 or V5), planning target volume (PTV), and relative lung parenchyma volume in emphysematous lung receiving 20 or 5 Gy or more (RLPV20 or 5; V20 or V5/100‐percentage of low‐attenuation volume) were evaluated. Results Performance status (PS), V20, V5, PTV, RLPV20, and RLPV5 were significantly higher in the lung injury group in the univariate analysis. Furthermore, RLPV20 was the most significant factor in the lung injury group in the multivariate analysis comprising PS, PTV, V20, and RLPV20. Conclusion RLPV20 and RLPV5 are useful in estimating lung inflammation. RLPV20 could be considered the most reliable risk factor for maintenance therapy with durvalumab following concurrent chemoradiotherapy in patients with unresectable locally advanced NSCLC.
Databáze: Directory of Open Access Journals
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