Respiratory medicine and research · 2025
Real-world management of unresectable stage III non-small-cell lung cancer: Impact of durvalumab consolidation therapy in French clinical practice.
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Chouaid Christos, Giraud Philippe, Wislez Marie, Pichon Eric, Stancu Alma, Debieuvre Didier, Girard Nicolas, Pérol Maurice, Quantin Xavier, Ano Sabine, Grela Françoise, Goyard Nina, Fore Mathieu, Magne Fanny, Pante Vanessa, Lemonnier-Videau Lydie, Falchero Lionel
Аннотация
BACKGROUND: Durvalumab consolidation therapy has improved survival after chemoradiotherapy in patients with advanced non-small-cell lung cancer (NSCLC). Our three-cohort study from France described the real-world effectiveness and safety of durvalumab in unresectable stage III NSCLC.
METHODS: We analysed three durvalumab-treated cohorts: the French PACIFIC-R cohort (n=342), the prospective KBP-2020-CPHG cohort (n=178), and the ESME lung cancer registry (n=604). Progression-free survival (PFS) and overall survival (OS) were assessed from start of durvalumab (in French PACIFIC-R and KBP-2020-CPHG) or end of radiotherapy (in ESME). Safety data were available for the French PACIFIC-R cohort.
RESULTS: In French PACIFIC-R, at a median follow-up of 39.4 months, median PFS was 22.6 months and median OS was not reached. At 3 years, OS was 61.1%. Median PFS was 13.0 months in patients with programmed death-ligand 1 (PD-L1) expression <1% versus 25.3 months in those with PD-L1 ≥1%. Pneumonitis/interstitial lung disease occurred in 17.8% of patients, with no fatal events. In KBP-2020-CPHG, median PFS was 18.5 months and median OS was not reached. Three-year OS was 55.0%. Patients with PD-L1 expression >50% had a 3-year OS rate of 68.4% compared to 48.5% in those with PD-L1 expression 1%-50%. In ESME, median PFS was 21.2 months and median OS was 50.7 months. The 3-year and 5-year OS rates were 61.3% and 46.9%, respectively. Among 308 patients with N2 stage disease, median PFS was 25.6 months and median OS was 56.4 months from NSCLC diagnosis.
CONCLUSIONS: Real-world evidence from three large French cohorts underscores the sustained effectiveness and manageable safety profile of durvalumab consolidation therapy after chemoradiotherapy in unresectable stage III NSCLC.
METHODS: We analysed three durvalumab-treated cohorts: the French PACIFIC-R cohort (n=342), the prospective KBP-2020-CPHG cohort (n=178), and the ESME lung cancer registry (n=604). Progression-free survival (PFS) and overall survival (OS) were assessed from start of durvalumab (in French PACIFIC-R and KBP-2020-CPHG) or end of radiotherapy (in ESME). Safety data were available for the French PACIFIC-R cohort.
RESULTS: In French PACIFIC-R, at a median follow-up of 39.4 months, median PFS was 22.6 months and median OS was not reached. At 3 years, OS was 61.1%. Median PFS was 13.0 months in patients with programmed death-ligand 1 (PD-L1) expression <1% versus 25.3 months in those with PD-L1 ≥1%. Pneumonitis/interstitial lung disease occurred in 17.8% of patients, with no fatal events. In KBP-2020-CPHG, median PFS was 18.5 months and median OS was not reached. Three-year OS was 55.0%. Patients with PD-L1 expression >50% had a 3-year OS rate of 68.4% compared to 48.5% in those with PD-L1 expression 1%-50%. In ESME, median PFS was 21.2 months and median OS was 50.7 months. The 3-year and 5-year OS rates were 61.3% and 46.9%, respectively. Among 308 patients with N2 stage disease, median PFS was 25.6 months and median OS was 56.4 months from NSCLC diagnosis.
CONCLUSIONS: Real-world evidence from three large French cohorts underscores the sustained effectiveness and manageable safety profile of durvalumab consolidation therapy after chemoradiotherapy in unresectable stage III NSCLC.