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(Slides)

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This study examined the treatment outcomes of patients with non-resectable Stage 3 non-small cell lung cancer (NSCLC) who received concurrent chemotherapy and radiotherapy followed by durvalumab, a PD-L1 inhibitor. The study aimed to determine the efficacy of additional immune checkpoint inhibitors (ICPi) for patients who progressed after this treatment regimen. <br /><br />The study included a total of 138 consecutive NSCLC patients who received chemo-RT and at least one dose of durvalumab between March 2016 and October 2020. Among the study cohort, 92 patients (47%) experienced disease progression on or after durvalumab treatment. <br /><br />The analysis found that patients who progressed within six months of starting durvalumab, referred to as "fast progressors," had a significantly higher rate of adenocarcinoma histology compared to "slow progressors." However, there were no significant differences in progression patterns between fast and slow progressors.<br /><br />The study also compared the survival outcomes of patients who received different post-durvalumab treatments. There were no significant differences in progression-free survival (PFS) or overall survival (OS) between the different treatment groups, including chemotherapy alone or in combination with ICPi. However, the survival rates with chemotherapy and ICPi were numerically higher. <br /><br />Multivariate analysis showed that age and neutrophil lymphocyte ratio (NLR) were significant factors for PFS, while age and high PD-L1 expression were significant factors for OS.<br /><br />In conclusion, this study suggests that there is no significant benefit in adding ICPi to the treatment regimen for patients with non-resectable Stage 3 NSCLC who progress after chemo-RT and durvalumab. The study emphasizes the importance of considering factors such as age, histology, and immune biomarkers in determining the most appropriate treatment approach for these patients. However, further research is needed to validate these findings and explore other treatment options for this patient population.

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Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

non-resectable Stage 3 non-small cell lung cancer

chemotherapy

radiotherapy

durvalumab

PD-L1 inhibitor

immune checkpoint inhibitors

disease progression

adenocarcinoma histology

progression-free survival

overall survival