2023 World Conference on Lung Cancer (Posters)-P2.02. Comprehensive Pneumonitis Assessment Among Inoperable Stage III NSCLC Patients Treated with Chemoradiotherapy-Immunotherapy Regimen

P2.02. Comprehensive Pneumonitis Assessment Among Inoperable Stage III NSCLC Patients Treated with Chemoradiotherapy-Immunotherapy Regimen - PDF(Abstract)

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This study aimed to assess the rates and severity of pneumonitis in inoperable Stage III non-small cell lung cancer (NSCLC) patients treated with a chemoradiotherapy-immunotherapy regimen. The researchers retrospectively reviewed electronic medical records of patients treated between 2018-2022. Patients who received concurrent or sequential chemotherapy-radiotherapy (cCRT and sCRT) followed by Durvalumab (an immunotherapy drug) were included. These patients were matched with an equal number of patients who did not receive Durvalumab. Cone beam CT (CBCT) and diagnostic CT (dCT) images were evaluated for radiologic pneumonitis. Statistical analysis was performed, and the multivariate analysis was conducted using logistic regression model.<br /><br />The study included a total of 146 patients, with a median age of 69 years. Most patients had adenocarcinoma or squamous cell carcinoma, and a percentage had specific targetable mutations. After a median follow-up of 17 months, the median progression-free survival (PFS) was longer for patients who received cCRT/sCRT plus Durvalumab compared to those who did not receive Durvalumab. The most common site of relapse was distant metastasis, and the median overall survival for the entire cohort was 32 months.<br /><br />The overall rates of clinical pneumonitis were higher in patients who received cCRT with or without Durvalumab compared to those who received sCRT with or without Durvalumab. Adjuvant Durvalumab and cCRT were identified as independent prognostic factors increasing the risk of clinical pneumonitis. However, dosimetric parameters were not associated with an increased risk of pneumonitis.<br /><br />The study concluded that adjuvant Durvalumab improved PFS in both cCRT and sCRT. Durvalumab and cCRT were independent prognostic factors associated with an increased risk of pneumonitis. These results are consistent with the findings of the Pacific trial. Further analysis of pseudoprogression and hyperprogression using the same patient population is ongoing.<br /><br />Overall, this study provides insights into the toxicities of multimodality therapy in the treatment of local-regional NSCLC. The findings highlight the importance of monitoring and managing pneumonitis in patients receiving these treatment regimens.

Asset Subtitle

Jayson Paragas

Meta Tag

Speaker Jayson Paragas

Topic Local-Regional NSCLC: Toxicities of Multimodality Therapy

Keywords

pneumonitis

inoperable Stage III non-small cell lung cancer

chemoradiotherapy-immunotherapy regimen

electronic medical records

Durvalumab

concurrent chemotherapy-radiotherapy

sequential chemotherapy-radiotherapy

Cone beam CT

diagnostic CT

radiologic pneumonitis