2023 World Conference on Lung Cancer (Posters)-P2.07. Stage 3 NSCLC Patients Progressing After Concurrent Chemo-Radiotherapy and Durvalumab- is There a Role for Another IO?

P2.07. Stage 3 NSCLC Patients Progressing After Concurrent Chemo-Radiotherapy and Durvalumab- is There a Role for Another IO? - PDF(Abstract)

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This presentation at WCLC 2023 discusses the treatment of unresectable stage III non-small cell lung cancer (NSCLC) patients who have progressed after concurrent chemo-radiotherapy and durvalumab. The study aimed to determine if there is a role for another immune checkpoint inhibitor (ICPi) in this patient population.<br /><br />The authors conducted a retrospective study of 138 NSCLC patients with unresectable stage III disease who received concurrent chemo-radiotherapy followed by durvalumab treatment between March 2016 and October 2020. Out of these patients, 92 progressed on or after durvalumab treatment and had no targetable mutations. The median follow-up time was 12.6 months.<br /><br />Results showed that 47% of patients progressed within six months of starting durvalumab treatment. Adenocarcinoma histology was significantly more common in early progressors. 68% of patients were treated for metastatic disease, with different treatment options including chemotherapy and ICPi, chemotherapy without ICPi, and ICPi alone. The median overall survival and progression-free survival from the onset of the next treatment were 14.7 months and 11.6 months, respectively. There was no significant difference in survival between the different treatment groups.<br /><br />On univariate survival analysis, treatment with chemotherapy and bevacizumab was associated with better prognosis, while ECOG PS1, progression within six months from the onset of durvalumab, and elevated neutrophil-to-lymphocyte ratio (NLR) were associated with poorer prognosis. Only NLR remained a significant poor prognostic factor on multivariate analysis.<br /><br />In conclusion, this study found no significant difference in survival with the addition of another ICPi to systemic treatment for patients with unresectable stage III NSCLC progressing after chemo-radiotherapy and durvalumab. However, survival with chemotherapy and ICPi appeared to be numerically higher. The results suggest that further research is needed to determine the optimal treatment approach for this patient population.

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Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

WCLC 2023

unresectable stage III NSCLC

non-small cell lung cancer

chemo-radiotherapy

durvalumab

immune checkpoint inhibitor

metastatic disease

adenocarcinoma histology

overall survival

progression-free survival