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Durvalumab following definitive chemoradiotherapy among patients with stage III NSCLC in the Thai population: a real-world, multicenter observational study

Year: 2025

Type: article

Abstract: Background: In locally advanced non-small cell lung cancer (LA-NSCLC), durvalumab as consolidation therapy following definitive chemoradiotherapy (CRT) was established as the standard of care. Given the heterogeneity of patients with LA-NSCLC, the present study evaluated the efficacy and safety of durvalumab in a real-world, multicenter observational study. Methods: Patients with LA-NSCLC, whose disease had not progressed following CRT and receiving ≥1 dose of durvalumab as part of the expanded access program (EAP) in Thailand and outside EAP, were included. In addition to descriptive statistics, survival probability was determined using the Kaplan-Meier method. Results: A total of 82 patients from 12 centers in Thailand were enrolled. The median age was 63 years, 74% were men, 72% had non-squamous NSCLC, and 20% of patients had an epidermal growth factor receptor (EGFR) mutation. Only 13.4% of patients were tested for programmed death-ligand 1 (PD-L1), and 54.5% had PD-L1 expression. Most patients (84%) received concurrent CRT, and carboplatin/paclitaxel was the most commonly used. Of the patients, 89% received radiotherapy (RT) dose ≥60 Gy with a median time of durvalumab initiation from the end of RT being 42 days. Overall, 57% of patients completed the 12-month treatment with a median of 24 cycles. Objective response rate (ORR) and disease control rate (DCR) were 41.3% and 86.7%, respectively. With a median follow-up time of 43.3 months, 2-year progression-free survival (PFS) and 2-year time to second objective disease progression (PFS2) were 63.1% and 81.6%, respectively. Immune-related adverse events (irAEs) of any grade and grade ≥ 3 were 25.6% and 9.8%, respectively. Pneumonitis was the most frequent irAE (17%), and 6% were grade ≥ 3, leading to discontinuation in six patients (7.3%). Conclusions: Durvalumab following definitive CRT demonstrated promising outcomes and was well-tolerated in this real-world study. These findings support the utilization of durvalumab for enhancing outcomes in patients with unresectable LA-NSCLC within Asian populations.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2025.1647385