Therapeutic advances in medical oncology · 2026
Clinical management and outcomes of relapsed NSCLC after chemoradiotherapy and durvalumab consolidation: real-world evidence from Germany.
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Evers Georg, Glanemann Franziska, Webendörfer Maximilian, Wiesweg Marcel, Görlich Dennis, Christoph Daniel C, Hoffknecht Petra, Zimmermann Heiner, Acker Fabian, Sebastian Martin, Kerkhoff Andrea, Mohr Michael, Lenz Georg, Hund Anna-Carina, Overbeck Tobias R, Frost Nikolaj, Faehling Martin, Brückl Wolfgang M, Kropf-Sanchen Cornelia, Schütte Wolfgang, Griesinger Frank, Reitnauer Lea E, Bleckmann Annalen
Аннотация
BACKGROUND: Despite recent advances in the treatment of locally advanced non-small cell lung cancer (NSCLC), most patients relapse after definitive chemoradiotherapy followed by durvalumab consolidation. Due to limited evidence on post-relapse management, no standard treatment approach has been established for this patient population.
OBJECTIVES: The objective of this study was to evaluate real-world treatment strategies and clinical outcomes in patients with NSCLC who experienced disease recurrence after durvalumab consolidation.
DESIGN: This was a multicenter, retrospective cohort study conducted across 12 German lung cancer centers.
METHODS: A total of 145 patients with recurrent NSCLC following chemoradiotherapy and durvalumab consolidation were analyzed. Clinical, pathological, and treatment-related data were collected, including smoking status, histology, molecular testing, therapeutic sequences, and survival outcomes. Overall survival (OS) and progression-free survival (PFS) were estimated and compared across subgroups according to relapse characteristics and post-relapse treatment strategies. Multivariate analyses were performed to identify independent prognostic factors.
RESULTS: The median OS from initial diagnosis was 27.1 months (95% confidence interval (CI): 22.5-31.8). After relapse, median OS was 12.2 months (95% CI: 9.9-14.4), and median PFS was 7.1 months (95% CI: 5.7-8.4). Approximately 70% of patients received systemic therapy after relapse, including platinum-based chemotherapy (18.6%), single-agent chemotherapy (18.6%), immune checkpoint inhibitors with or without chemotherapy (28.3%), and targeted therapy (4.8%). Patients treated with immune checkpoint inhibitors or targeted therapies showed a numerical improvement in OS compared with chemotherapy alone, although this difference did not reach statistical significance. Multivariate analysis identified first-line post-relapse treatment, Eastern Cooperative Oncology Group performance status, and histologic subtype as independent prognostic factors for OS.
CONCLUSION: Patients with relapsed NSCLC after durvalumab consolidation have a poor prognosis and remain a therapeutically underserved population. Clinical outcomes appear to be influenced by performance status, histology, and the choice of post-relapse therapy. Prospective clinical trials are urgently needed to define optimal treatment strategies for these patients.
OBJECTIVES: The objective of this study was to evaluate real-world treatment strategies and clinical outcomes in patients with NSCLC who experienced disease recurrence after durvalumab consolidation.
DESIGN: This was a multicenter, retrospective cohort study conducted across 12 German lung cancer centers.
METHODS: A total of 145 patients with recurrent NSCLC following chemoradiotherapy and durvalumab consolidation were analyzed. Clinical, pathological, and treatment-related data were collected, including smoking status, histology, molecular testing, therapeutic sequences, and survival outcomes. Overall survival (OS) and progression-free survival (PFS) were estimated and compared across subgroups according to relapse characteristics and post-relapse treatment strategies. Multivariate analyses were performed to identify independent prognostic factors.
RESULTS: The median OS from initial diagnosis was 27.1 months (95% confidence interval (CI): 22.5-31.8). After relapse, median OS was 12.2 months (95% CI: 9.9-14.4), and median PFS was 7.1 months (95% CI: 5.7-8.4). Approximately 70% of patients received systemic therapy after relapse, including platinum-based chemotherapy (18.6%), single-agent chemotherapy (18.6%), immune checkpoint inhibitors with or without chemotherapy (28.3%), and targeted therapy (4.8%). Patients treated with immune checkpoint inhibitors or targeted therapies showed a numerical improvement in OS compared with chemotherapy alone, although this difference did not reach statistical significance. Multivariate analysis identified first-line post-relapse treatment, Eastern Cooperative Oncology Group performance status, and histologic subtype as independent prognostic factors for OS.
CONCLUSION: Patients with relapsed NSCLC after durvalumab consolidation have a poor prognosis and remain a therapeutically underserved population. Clinical outcomes appear to be influenced by performance status, histology, and the choice of post-relapse therapy. Prospective clinical trials are urgently needed to define optimal treatment strategies for these patients.