Adding Durvalumab to Neoadjuvant Chemotherapy in Stage IIIA (N2) NSCLC
Posted: Friday, July 30, 2021
Adding an immune checkpoint inhibitor to standard platinum-based neoadjuvant chemotherapy in the perioperative setting may ultimately improve outcomes for patients with resectable stage IIIA non–small-cell lung cancer (NSCLC) with ipsilateral or subcarinal mediastinal lymphatic spread (N2), according to the results of the multicenter phase II SAKK 16/14 trial. The study findings were published in the Journal of Clinical Oncology.
“The addition of perioperative durvalumab to neoadjuvant chemotherapy in patients with stage IIIA (N2) non–small-cell lung cancer is safe and exceeds historical data of chemotherapy alone,” stated Miklos Pless, MD, of Cantonal Hospital Winterthur, Switzerland, and colleagues.
In this single-arm trial, 67 patients received neoadjuvant treatment with 3 cycles of cisplatin and docetaxel followed by 2 doses of durvalumab at 750 mg once every 2 weeks. Durvalumab was continued for 1 year after surgery.
Of the 55 patients who underwent resection, 62% and 18% achieved a major pathologic response and a complete pathologic response, respectively. The 1-year event-free survival rate of 73% with the addition of durvalumab exceeded the rate of 48% observed in the SAKK 16/00 with neoadjuvant chemotherapy alone. Median event-free survival and overall survival were not reached after 28.6 months of median follow-up. As for safety, 88% of patients had a grade ≥ 3 adverse event, including two fatal events that were determined not to be related to treatment.
“The fact that the high pathologic remission rate is associated with overall outcome, which has also been shown in other trials, has implications for the design of future trials,” concluded the authors.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
