View in EDS

Does Adjuvant Durvalumab Improve Local Control Following Chemoradiotherapy for Non-Small Cell Lung Cancer?

Saved in:
Bibliographic Details
Title: Does Adjuvant Durvalumab Improve Local Control Following Chemoradiotherapy for Non-Small Cell Lung Cancer?
Authors: Zakharia, A.1 (AUTHOR), III, W.R. Bodner1 (AUTHOR), Halmos, B.1 (AUTHOR), Garg, M.K.2 (AUTHOR), Gucalp, R.1 (AUTHOR), Cheng, H.1 (AUTHOR), Stiles, B.M.1 (AUTHOR), Ohri, N.2 (AUTHOR)
Source: International Journal of Radiation Oncology, Biology, Physics. 2022 Supplement, Vol. 114 Issue 3, pS164-S164. 1p.
Subjects: Non-small-cell lung carcinoma, Proportional hazards models, Chemoradiotherapy, Rectal cancer
Abstract: Analyses of the PACIFIC trial have demonstrated that treatment with durvalumab after chemoradiotherapy (CRT) for stage III non-small cell lung cancer (NSCLC) improves overall survival, progression-free survival (PFS), and intrathoracic disease control. We reviewed outcomes for patients treated with and without adjuvant durvalumab to assess if durvalumab improves local control of the tumors and lymph nodes treated with radiotherapy. We reviewed locally advanced NSCLC patients who underwent PET staging and received definitive concurrent CRT at our institution between 2007 and 2021. Patients with disease progression or death within six weeks after radiotherapy completion were excluded. Based on previous patterns-of-failure analyses, tumors and lymph nodes were categorized as high- or low-risk for local failure using a metabolic tumor volume cutoff of 25 cc. Kaplan-Meier curves and Cox proportional hazards models were used to test durvalumab receipt as a predictor of PFS. Competing risks analyses were performed to test durvalumab receipt as a predictor of local progression of treated tumors and lymph nodes. Progression at other sites and death without progression were treated as competing risks. 197 patients with 567 hypermetabolic lesions treated with radiotherapy (192 pulmonary tumors, 375 lymph nodes) met inclusion criteria. Among 84 patients with known PD-L1 tumor proportion score (TPS), TPS was <1% for 28 patients (33%), 1-49% for 34 patients (40%), and ≥50% for 22 patients (26%). Sixty-three patients (32%) received adjuvant durvalumab. The median follow-up duration was 57 months for patients who did not receive durvalumab and 27 months for patients who received durvalumab. The median PFS duration for patients who received durvalumab was 16.2 months, compared to 10.5 months for patients who did not receive durvalumab (HR=0.70, 95% CI 0.48 to 1.02, p=0.064). However, we found no significant association between durvalumab receipt and cumulative incidence rate (CIR) of local failure for high- or low-risk lesions (See Table). In a multivariable model adjusted for lesion size and durvalumab receipt, high PD-L1 TPS was associated with reduced risk of local failure (p=0.033). For locally advanced NSCLC patients treated with definitive CRT, we did not find that adjuvant durvalumab improves local disease control. This suggests that durvalumab improves outcomes by preventing 'out-of-field' progression. Strategies to improve local control of large tumors and lymph nodes should still be explored. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 159165481
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Does Adjuvant Durvalumab Improve Local Control Following Chemoradiotherapy for Non-Small Cell Lung Cancer?
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zakharia%2C+A%2E%22&quot;&gt;Zakharia, A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22III%2C+W%2ER%2E+Bodner%22&quot;&gt;III, W.R. Bodner&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Halmos%2C+B%2E%22&quot;&gt;Halmos, B.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Garg%2C+M%2EK%2E%22&quot;&gt;Garg, M.K.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gucalp%2C+R%2E%22&quot;&gt;Gucalp, R.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cheng%2C+H%2E%22&quot;&gt;Cheng, H.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stiles%2C+B%2EM%2E%22&quot;&gt;Stiles, B.M.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ohri%2C+N%2E%22&quot;&gt;Ohri, N.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22&quot;&gt;International Journal of Radiation Oncology, Biology, Physics&lt;/searchLink&gt;. 2022 Supplement, Vol. 114 Issue 3, pS164-S164. 1p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Non-small-cell+lung+carcinoma%22&quot;&gt;Non-small-cell lung carcinoma&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Proportional+hazards+models%22&quot;&gt;Proportional hazards models&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Chemoradiotherapy%22&quot;&gt;Chemoradiotherapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rectal+cancer%22&quot;&gt;Rectal cancer&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Analyses of the PACIFIC trial have demonstrated that treatment with durvalumab after chemoradiotherapy (CRT) for stage III non-small cell lung cancer (NSCLC) improves overall survival, progression-free survival (PFS), and intrathoracic disease control. We reviewed outcomes for patients treated with and without adjuvant durvalumab to assess if durvalumab improves local control of the tumors and lymph nodes treated with radiotherapy. We reviewed locally advanced NSCLC patients who underwent PET staging and received definitive concurrent CRT at our institution between 2007 and 2021. Patients with disease progression or death within six weeks after radiotherapy completion were excluded. Based on previous patterns-of-failure analyses, tumors and lymph nodes were categorized as high- or low-risk for local failure using a metabolic tumor volume cutoff of 25 cc. Kaplan-Meier curves and Cox proportional hazards models were used to test durvalumab receipt as a predictor of PFS. Competing risks analyses were performed to test durvalumab receipt as a predictor of local progression of treated tumors and lymph nodes. Progression at other sites and death without progression were treated as competing risks. 197 patients with 567 hypermetabolic lesions treated with radiotherapy (192 pulmonary tumors, 375 lymph nodes) met inclusion criteria. Among 84 patients with known PD-L1 tumor proportion score (TPS), TPS was &lt;1% for 28 patients (33%), 1-49% for 34 patients (40%), and ≥50% for 22 patients (26%). Sixty-three patients (32%) received adjuvant durvalumab. The median follow-up duration was 57 months for patients who did not receive durvalumab and 27 months for patients who received durvalumab. The median PFS duration for patients who received durvalumab was 16.2 months, compared to 10.5 months for patients who did not receive durvalumab (HR=0.70, 95% CI 0.48 to 1.02, p=0.064). However, we found no significant association between durvalumab receipt and cumulative incidence rate (CIR) of local failure for high- or low-risk lesions (See Table). In a multivariable model adjusted for lesion size and durvalumab receipt, high PD-L1 TPS was associated with reduced risk of local failure (p=0.033). For locally advanced NSCLC patients treated with definitive CRT, we did not find that adjuvant durvalumab improves local disease control. This suggests that durvalumab improves outcomes by preventing &#39;out-of-field&#39; progression. Strategies to improve local control of large tumors and lymph nodes should still be explored. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=159165481
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2022.07.657
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 1
        StartPage: S164
    Subjects:
      – SubjectFull: Non-small-cell lung carcinoma
        Type: general
      – SubjectFull: Proportional hazards models
        Type: general
      – SubjectFull: Chemoradiotherapy
        Type: general
      – SubjectFull: Rectal cancer
        Type: general
    Titles:
      – TitleFull: Does Adjuvant Durvalumab Improve Local Control Following Chemoradiotherapy for Non-Small Cell Lung Cancer?
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Zakharia, A.
      – PersonEntity:
          Name:
            NameFull: III, W.R. Bodner
      – PersonEntity:
          Name:
            NameFull: Halmos, B.
      – PersonEntity:
          Name:
            NameFull: Garg, M.K.
      – PersonEntity:
          Name:
            NameFull: Gucalp, R.
      – PersonEntity:
          Name:
            NameFull: Cheng, H.
      – PersonEntity:
          Name:
            NameFull: Stiles, B.M.
      – PersonEntity:
          Name:
            NameFull: Ohri, N.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 02
              M: 11
              Text: 2022 Supplement
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 114
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1