ASTRO 2019: Characterizing Patterns of Disease Progression in Stage III Lung Cancer
Posted: Thursday, September 19, 2019
Based on exploratory analyses from the phase III PACIFIC trial to characterize patterns of disease progression in the treatment of stage III non–small cell lung cancer (NSCLC), the site of first disease progression in most patients was inside the thorax, regardless of whether they received or did not receive immunotherapy with durvalumab. However, “fewer patients receiving durvalumab experienced local and/or distant [disease] progression,” according to Andreas Rimner, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues. Their study findings were presented at the 2019 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract LBA6) in Chicago.
“To have a treatment that truly reduces the rate of lesions developing distantly, and reduces the frequency of these distant lesions, is a major step forward and really improves the outlook for these patients,” stated Dr. Rimner in an ASTRO press release.
The PACIFIC trial included 713 patients: 476 were randomly assigned to receive durvalumab and 237, placebo. All of the study patients had completed chemoradiation therapy first.
As of March 2018, the rate of disease progression or death was higher in the placebo group than in the durvalumab group (64.6% vs. 45.4%). In addition, local-only (intrathoracic) disease progression occurred in 48.1% of the placebo group and 36.6% of the durvalumab group, respectively, and distant-only (extrathoracic) disease progression occurred in 13.1% and 6.9%, respectively. Furthermore, the brain was found to be the most common site of disease progression. And, durvalumab improved the median time to first disease progression in each region compared with placebo.
“The addition of this immunotherapy drug following concurrent chemoradiation really needs to be implemented as the standard of care for these patients,” Dr. Rimner declared.
Disclosure: The study authors’ disclosure information may be found at astro.org.
