WCLC 2025 - Posters & ePosters-P2.08 .21 Mapping Early Failure After CRT and Durvalumab in NSCLC: Insights From a Real-World Cohort

Pdf Summary

This retrospective multicenter real-world study from five Polish oncology centers analyzed early treatment failure patterns and subsequent therapies in 60 patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with standard concurrent chemoradiotherapy (CRT) followed by durvalumab. The aim was to characterize timing and location of relapses and evaluate the impact of different local therapies on outcomes.<br /><br />Key findings showed that distant metastases—most commonly lung (42%), brain (20%), and liver (11%)—occurred earlier than local relapses. Patients experiencing local relapse had a significantly longer time to next treatment (TNT) than those with distant progression (17.1 vs 9.9 months; p=0.0088). Importantly, receipt of radical local therapy (e.g., surgery or ablative radiotherapy) after progression was associated with markedly improved time to next systemic therapy (TNST) compared to those receiving palliative radiotherapy or no local therapy (29.1 vs 12.6 months; p=0.016). Palliative radiotherapy did not extend TNT or TNST.<br /><br />Overall median TNT was 11.6 months, and median TNST was 13.2 months. The treatment sequences were heterogeneous, reflecting real-world practice variability, including induction chemotherapy use, durvalumab duration, and reasons for discontinuation. 54 of 60 patients received further systemic or local therapy after progression.<br /><br />This study highlights the importance of early imaging to detect distant metastases sooner, as distant progression limits survival more than local recurrence. The real-world data support an aggressive local therapy approach for localized relapse in stage III NSCLC to extend systemic therapy-free intervals, while palliative radiotherapy alone offers limited benefit. These findings reinforce and extend prior randomized trial observations to patients with comorbidities and heterogeneous treatments typical in everyday clinical oncology.<br /><br />In conclusion, early monitoring and aggressive management of local relapse after CRT and durvalumab can prolong treatment benefits in stage III NSCLC, emphasizing the need for individualized salvage strategies in routine practice.

Asset Subtitle

Maja Lisik-Habib

Meta Tag

Speaker Maja Lisik-Habib

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

stage III NSCLC

concurrent chemoradiotherapy

durvalumab

early treatment failure

local relapse

distant metastases

radical local therapy

time to next treatment

palliative radiotherapy