WCLC 2025 - Posters & ePosters-EP.08.48 PD-L1 Expression and Efficacy of Durvalumab Consolidation in Stage III EGFR-Mutant Non-Small Cell Lung Cancer: A Multicenter Real-World Study

EP.08.48 PD-L1 Expression and Efficacy of Durvalumab Consolidation in Stage III EGFR-Mutant Non-Small Cell Lung Cancer: A Multicenter Real-World Study

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This multicenter real-world study investigates the efficacy of durvalumab consolidation therapy after concurrent chemoradiotherapy (CCRT) in patients with unresectable stage III non-small cell lung cancer (NSCLC), focusing on the impact of EGFR mutation status and PD-L1 expression.<br /><br />Approximately 18% of lung cancer cases are diagnosed at stage III. While CCRT followed by durvalumab consolidation shows improved outcomes in NSCLC generally, patients with EGFR-mutant NSCLC tend to derive less benefit compared to those without EGFR mutations. Previous studies, including the PACIFIC trial, reported no significant progression-free survival (PFS) or overall survival (OS) differences between durvalumab and placebo in the EGFR-mutant subgroup, although some reports indicated longer PFS when EGFR tyrosine kinase inhibitors were used post-CCRT.<br /><br />Additional research highlights varied responses based on molecular alterations: patients with EGFR or ERBB2 mutations had shorter disease-free survival and PFS compared to those without these variants. Conversely, NSCLC patients negative for EGFR/ALK mutations showed better responses to durvalumab, and subsets with high PD-L1 expression (≥25%) might respond favorably to immunotherapy.<br /><br />The current study concludes that durvalumab consolidation offers comparable benefits in EGFR-mutant patients with high PD-L1 expression (≥50%) versus EGFR wild-type patients. These findings suggest that durvalumab could be a viable treatment option for unresectable stage III EGFR-mutant NSCLC characterized by elevated PD-L1 levels, although the benefit is less clear in those with lower PD-L1 or differing molecular profiles. <br /><br />Overall, the study underscores the importance of considering both EGFR mutation and PD-L1 expression status when selecting consolidation therapies for stage III NSCLC, indicating potential for durvalumab to improve outcomes in carefully selected patient subgroups.

Asset Subtitle

Insu Kim

Meta Tag

Speaker Insu Kim

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

durvalumab

consolidation therapy

concurrent chemoradiotherapy

unresectable stage III non-small cell lung cancer

EGFR mutation

PD-L1 expression

progression-free survival

overall survival

immunotherapy response

molecular alterations