2024 World Conference on Lung Cancer (WCLC) - Posters-P1.08D.03 Induction Durvalumab Followed by Chemoradiation and Consolidation Durvalumab for Stage III Non-Small Cell Lung Cancer (NSCLC)

P1.08D.03 Induction Durvalumab Followed by Chemoradiation and Consolidation Durvalumab for Stage III Non-Small Cell Lung Cancer (NSCLC)

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This clinical trial explored the use of induction durvalumab prior to standard concurrent chemoradiation therapy followed by consolidation durvalumab in patients with unresectable stage III non-small cell lung cancer (NSCLC). The current standard care involves chemoradiation followed by durvalumab as consolidation therapy to improve survival, though recurrence remains high. With evolving evidence supporting neoadjuvant checkpoint inhibition, this trial evaluated a regimen incorporating a single cycle of durvalumab induction.<br /><br />Due to pandemic-related enrollment issues, only 10 patients participated in this preliminary safety assessment, with planned recruitment initially at 54. The study's primary objectives were to determine the 12-month progression-free survival (PFS) post-chemoradiation and to assess safety and feasibility of this treatment regimen. Secondary objectives included estimating the objective response rate and exploring correlations between outcomes, toxicity, PD-L1 expression, tumor mutation burden (TMB), and immune response.<br /><br />The results showed no significant new safety concerns from adding induction durvalumab. Although the trial was closed early, limiting definitive conclusions, a 30% 12-month PFS was recorded, which fell short of historical controls from the PACIFIC trial, where the 12-month PFS was 55.9%. Patients with high TMB had no progression at 12 months. The overall response rate was 70%, with a median PFS of 8.36 months.<br /><br />Adverse events of grades 1-3 were recorded, predominantly non-hematologic, with a subset experiencing anemia, neutropenia, and various other conditions. Most patients had adenocarcinoma or squamous histology and received chemoradiation with carboplatin-based regimens.<br /><br />The trial underscores the feasibility of incorporating durvalumab induction but highlights challenges in meeting efficacy outcomes due to limited enrollment. Continued investigation in larger cohorts is suggested to better understand the potential benefits of this approach.

Asset Subtitle

Rachel Sanborn

Meta Tag

Speaker Rachel Sanborn

Topic Local-Regional NSCLC

Keywords

induction durvalumab

concurrent chemoradiation

consolidation therapy

non-small cell lung cancer

progression-free survival

immune response

tumor mutation burden

adverse events

objective response rate

checkpoint inhibition