2024 World Conference on Lung Cancer (WCLC) - Posters-P1.08D.01 The Efficacy of Durvalumab after Concurrent Chemoradiotherapy for EGFR-Mutated Stage III Non-Small Cell Lung Cancer (NEJ063)

P1.08D.01 The Efficacy of Durvalumab after Concurrent Chemoradiotherapy for EGFR-Mutated Stage III Non-Small Cell Lung Cancer (NEJ063)

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This retrospective cohort study explores the efficacy and safety of durvalumab following concurrent chemoradiotherapy (CCRT) in patients with epidermal growth factor receptor (EGFR)-mutant stage III non-small cell lung cancer (NSCLC), compared to CCRT alone. The study was conducted across 48 centers and enrolled 220 patients, with 190 ultimately analyzed after excluding those with genomic testing following recurrence and other criteria mismatches. Key outcomes were progression-free survival (PFS) and overall survival (OS), with safety assessed through adverse event (AE) frequency, particularly looking at tyrosine kinase inhibitors (TKIs) following durvalumab.<br /><br />The final propensity score-matched cohort comprised 130 patients split evenly between those receiving durvalumab and those receiving CCRT alone. Results demonstrated that durvalumab prolonged median PFS to 23.0 months, compared to 12.1 months for CCRT alone, showing a hazard ratio of 0.56 (p=0.01), indicating a significant reduction in the risk of progression. However, the OS benefit was less pronounced, with statistical non-significance (HR 0.63, p=0.25).<br /><br />The study also evaluated the frequency of grade 3 or higher adverse events (AEs) from subsequent TKI therapy and found a decrease in severe AEs of osimertinib when initiated six months after completing durvalumab. This underscores the need for cautious timing when integrating TKIs in this treatment regimen.<br /><br />Despite retrospective limitations, such as the unconfirmed timing of genomic testing in prior studies, this study highlights the potential PFS benefit of integrating durvalumab in treating EGFR-mutant stage III NSCLC. The authors recommend further randomized clinical trials to ascertain the optimal incorporation of durvalumab and osimertinib post-CCRT.

Asset Subtitle

Gen Kida

Meta Tag

Speaker Gen Kida

Topic Local-Regional NSCLC

Keywords

durvalumab

chemoradiotherapy

EGFR-mutant

NSCLC

progression-free survival

overall survival

adverse events

tyrosine kinase inhibitors

osimertinib

retrospective cohort study