2022 World Conference on Lung Cancer (ePosters)-EP05.01-006. Population Kinetic Assessment of Chemoradiation for Locally Advanced Non-Small Cell Lung Cancer (NSCLC)

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A study conducted by researchers at the University of Ottawa and The Ottawa Hospital Research Institute in Canada aimed to evaluate the population kinetics of progression-free survival (PFS) and overall survival (OS) curves in patients with locally advanced non-small cell lung cancer (NSCLC) who received chemoradiation therapy. The researchers used exponential decay nonlinear regression analysis (EDNLRA) to analyze the curves and calculate half-lives.<br /><br />The study utilized published randomized trials of chemoradiation in locally advanced NSCLC, and used an online application to digitize the PFS curves derived from 50 patients each. The curves were classified as fitting either 1-phase decay or 2-phase decay models. The 2-phase decay models indicated the presence of two distinct subpopulations with differing rates of progression or death. The researchers calculated the relative size and half-lives of these subpopulations.<br /><br />The results of the study showed that, on average, about 15% of patients treated with chemoradiation for locally advanced NSCLC were cured. The PFS half-life for patients who were destined to recur was approximately 9.3 months. The PFS half-life for the potentially cured subpopulation was overestimated due to wide confidence intervals resulting from the calculated half-life being longer than the average follow-up duration.<br /><br />The study also revealed that a proportion of patients who remained recurrence-free at different time intervals following treatment initiation would eventually experience recurrence. For example, about 28% of patients remaining recurrence-free at 3 years, 6% at 5 years, and 0.1% at 10 years would go on to later recurrence.<br /><br />In addition, the study examined the impact of the immunotherapy drug durvalumab on PFS in the PACIFIC trial. The results showed that durvalumab decreased the proportion of patients in the rapidly recurring subpopulation. The PFS half-life for the rapidly recurring subpopulation was similar on both study arms, indicating different responses to immunotherapy. The PFS half-life for the potentially cured subpopulation was shorter in the durvalumab arm, suggesting the possibility of a third subpopulation with delayed recurrence but not cure.<br /><br />Overall, this study provides insights into the population kinetics of PFS and OS curves in NSCLC patients receiving chemoradiation therapy. It highlights the proportion of patients who are cured, the rates of progression or death, and the potential impact of immunotherapy on these outcomes.

Asset Subtitle

David J. Stewart

Meta Tag

Speaker David J. Stewart

Topic Locally Advanced Non-small Cell Lung Cancer - Chemoradiotherapy and Radiotherapy

Keywords

University of Ottawa

chemoradiation therapy

non-small cell lung cancer

PFS curves

recurrence

immunotherapy drug

durvalumab

PACIFIC trial

rapidly recurring subpopulation

rates of progression or death