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David S. Ettinger, MD, FACP, FCCP

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5-Year PACIFIC Follow-Up: Durvalumab in Stage III NSCLC

By: Celeste L. Dixon
Posted: Friday, April 1, 2022

The PACIFIC trial’s research team said that with its updated 5-year exploratory analyses of the PD-L1 inhibitor durvalumab versus placebo, a new benchmark for the standard of care has been reached for patients with unresectable, stage III non–small cell lung cancer whose disease had not progressed after chemoradiotherapy. These analyses of PACIFIC, a phase III trial, found that the estimated 5-year overall survival rate was 42.9% with durvalumab versus 33.4% with placebo, and the estimated 5-year progression-free survival rate was 33.1% versus 19.0%, respectively. Scott J. Antonia, MD, PhD, currently of Duke Cancer Center, Durham, North Carolina, and colleagues reported these results in the Journal of Clinical Oncology.

The overall survival and progression-free survival benefits favored durvalumab in all prespecified patient subgroups, the investigators noted, and the safety profile was manageable. A total of 709 patients, randomly assigned 2:1, received the immunotherapeutic agent or placebo for 1 year; they were stratified by age, sex, and smoking history and could have any PD-L1 tumor status.

About half the patients who responded to durvalumab had ongoing responses at 5 years. The overall response rate was approximately 10% higher with durvalumab than with placebo. The updated overall survival was consistent with that of the primary analysis, with durvalumab associated with a 28% reduction in the risk of death.

“This biologically important and clinically relevant finding provides long-term evidence for a sustained improvement in local disease control with durvalumab,” Dr. Antonia and co-researchers noted. “Furthermore, it supports a role for durvalumab in the treatment of patients with earlier-stage cancer.”

Disclosure: The study authors’ disclosure information can be found at ascopubs.org.


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