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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, October 7, 2024
Definitive radiation therapy with concurrent and consolidative use of the monoclonal antibody durvalumab may prove to be an option for some patients with inoperable, locally advanced non–small cell lung cancer (NSCLC) who have been deemed ineligible for concurrent chemoradiation therapy. Emily Lebow, MD, of the University of Pennsylvania, Philadelphia, and colleagues found that the approach showed promising rates of survival outcomes in this patient population. The team presented the results of their open-label, phase II trial at the 2024 American Society for Radiology Oncology (ASTRO) Annual Meeting (Abstract 188).
A total of 53 patients with inoperable, locally advanced NSCLC unselected by PD-L1 expression who were treated with conventionally fractionated definitive radiation therapy (60 Gy in 30 fractions) were included in the single-arm, multicenter study. Concurrent durvalumab (1,500 mg every 4 weeks) was initiated within 7 days of the start of radiation therapy and continued for up to 13 cycles. The median age of participants was 80.6 years; 15% had Karnofsky Performance Status (KPS) scores of 50 to 60, 77% had KPS scores of 70 to 80, and 8% had a KPS score of 90. The median number of durvalumab cycles was eight, and median follow-up was 19.4 months at the time of analysis.
At primary analysis, the investigators reported that the lower boundary of the one-sided 95% CI of 2-year progression-free survival was 28%, which was above their prespecified threshold of 20%. In secondary analyses, they reported a median progression-free survival of 14 months. The 6-, 12-, and 24-month progression-free survival rates were 80%, 56%, and 39%, respectively. The median overall survival was 25 months, and the 6-, 12-, and 24-month overall survival rates were 84%, 79%, and 53%, respectively. On univariable Cox analysis of progression-free survival, KPS score, PD-L1 status, and number of durvalumab cycles were significantly associated with progression-free survival. Similarly, on univariable Cox analysis of overall survival, KPS score, PD-L1 status, and number of durvalumab cycles were significantly associated with overall survival.
Disclosure: Dr. Lebow reported no conflicts of interest.
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