WCLC 2025 - Posters & ePosters-EP.17.12 Utility of CT Scans & Blood Tests After Maintenance Durvalumab Post Chemort in Stage III NSCLC Patients

Pdf Summary

This retrospective study evaluated the utility and clinical impact of follow-up CT scans and blood tests in stage III non-small cell lung cancer (NSCLC) patients treated with one year of maintenance durvalumab after chemoradiotherapy (chemoRT) at The Royal Marsden Hospital, London. The phase 3 PACIFIC trial previously established the benefit of durvalumab maintenance, with imaging every 8 weeks during treatment and every 12 weeks thereafter, but the role of regular blood test surveillance remained unclear.<br /><br />The study included 60 patients who completed one year post-durvalumab, analyzing adherence to 3-monthly (3M) CT scans and corresponding clinical outcomes. Compliance with 3M CT scans was high (92.8%). Scan-triggered further imaging rates were 14.2% at 3 months, 11.5% at 6 months, and 4% at 9 months, primarily PET-CT. Medication changes and specialist referrals ranged from 4% to 9.6%. Importantly, patients with baseline CT changes like suspected tumor regrowth, pneumonitis, or pleural effusions had higher progressive disease (PD) rates, while none without baseline lesions progressed. No PD occurred at 12 months. Since the observed ~10% scan-related intervention rate was below the predefined 20% threshold, the authors suggest reducing scan frequency from 3 to 6 months.<br /><br />Regarding blood tests (full blood count, urea/electrolytes, liver and thyroid function), 72 patients had baseline panels. Follow-up test adherence declined over time (79% at 3 months down to ~35% at later points), and only 20% had routine 3M monitoring. However, more than half of tests revealed clinically significant abnormalities requiring intervention, emphasizing the value of blood test follow-up despite inconsistent adherence.<br /><br />In conclusion, adherence to scheduled CT scans post-durvalumab was strong and clinically useful, supporting a less frequent scanning schedule. Conversely, blood test surveillance was variable but proved important for detecting treatable abnormalities, justifying its continuation in follow-up care for stage III NSCLC patients after chemoRT and durvalumab.

Asset Subtitle

Amelia Muñoz-Lerma

Meta Tag

Speaker Amelia Muñoz-Lerma

Topic Global Health, Health Services, and Health Economics

Keywords

stage III non-small cell lung cancer

durvalumab maintenance therapy

chemoradiotherapy

follow-up CT scans

blood test surveillance

PACIFIC trial

progressive disease rates

scan frequency reduction

clinical outcomes

treatable blood test abnormalities