Durvalumab Consolidation After Chemoradiotherapy in Elderly Patients With Unresectable Stage III NSCLC: A Real-World Multicenter Study

被引：10

作者：

Park, Ji Eun ^{[1
]}

Hong, Kyung Soo ^{[2
]}

Choi, Sun Ha ^{[1
]}

Lee, Shin Yup ^{[1
]}

Shin, Kyeong-Cheol ^{[2
]}

Jang, Jong Geol ^{[2
]}

Kwon, Yong Shik ^{[3
]}

Park, Sun Hyo ^{[3
]}

Choi, Keum-Ju ^{[4
]}

Jung, Chi Young ^{[4
]}

Eom, Jung Seop ^{[5
]}

Kim, Saerom ^{[5
]}

Seol, Hee Yun ^{[5
]}

Kim, Jehun ^{[6
]}

Kim, Insu ^{[7
]}

Park, Jin Han ^{[8
]}

Kim, Tae Hoon ^{[9
]}

Ahn, June Hong ^{[2
,10
,11
]}

机构：

[1] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Daegu, South Korea

[2] Yeungnam Univ, Coll Med, Dept Internal Med, Daegu, South Korea

[3] Keimyung Univ, Sch Med, Dept Internal Med, Busan, South Korea

[4] Daegu Catholic Univ, Coll Med, Dept Internal Med, Daegu, South Korea

[5] Pusan Natl Univ, Coll Med, Dept Internal Med, Busan, South Korea

[6] Kosin Univ, Coll Med, Dept Internal Med, Busan, South Korea

[7] Dong A Univ, Coll Med, Dept Internal Med, Busan, South Korea

[8] Inje Univ, Coll Med, Dept Internal Med, Busan, South Korea

[9] Gyeongsang Natl Univ, Sch Med, Dept Internal Med, Chang Won, South Korea

[10] Yeungnam Univ, Coll Med, Dept Internal Med, Div Pulmonol & Allergy, 170 Hyeonchung Ro, Daegu 42415, South Korea

[11] Yeungnam Univ, Resp Ctr, Med Ctr, 170 Hyeonchung Ro, Daegu 42415, South Korea

来源：

CLINICAL LUNG CANCER | 2024年 / 25卷 / 04期

关键词：

Non-small cell lung cancer; Real-world data; CELL LUNG-CANCER; CONCURRENT CHEMORADIOTHERAPY;

D O I：

10.1016/j.cllc.2024.02.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Durvalumab consolidation is now the standard-of-care after concurrent chemoradiotherapy in patients with unresectable stage III non-small-cell lung cancer. Our multicenter retrospective study of 286 patients showed that elderly patients had similar survival outcomes but experienced more adverse events (AEs) than younger patients. Careful patient selection and AE monitoring are needed during durvalumab consolidation in elderly patients. Background: The PACIFIC trial demonstrated survival benefit of durvalumab after concurrent chemoradiotherapy (CCRT) in unresectable stage III non-small-cell lung cancer. Data on the effectiveness and safety of durvalumab in elderly patients is lacking. Methods: This retrospective study was conducted between September 2017 and September 2022. Progression-free survival (PFS), overall survival (OS), recurrence patterns, first subsequent treatment after recurrence, factors associated with survival outcomes, and adverse events (AEs) were compared. Results: Of the 286 patients, 120 (42.0%) were >= 70 years and 166 (58.0%) were < 70 years. The median PFS (17.7 vs. 19.4 months; P = .43) and median OS (35.7 months vs. not reached; P = .13) were similar between 2 groups. Proportion of patients who completed durvalumab was lower in elderly patients (27.5% vs. 39.2%; P = .040). In elderly patients, ECOG PS 0 or 1 was associated with better PFS, and being male and having received a cisplatin-based regimen during CCRT were factors associated with better and worse OS, respectively. In patients aged < 70 years, a PD-L1 >= 50% was associated with improved PFS and OS. Elderly patients experienced more treatment-related AEs, grade 3/4 AEs, permanent discontinuation of durvalumab, and treatment-related deaths. Among the AEs leading to permanent discontinuation or death, pulmonary AE was significantly more common in elderly patients. Conclusion: Durvalumab demonstrated similar outcomes in elderly compared to younger patients. However, AEs were more common in elderly patients. Thus, judicious selection of patients and chemotherapy regimens, coupled with careful AE monitoring, are important factors for ensuring optimal durvalumab treatment.

引用

页码：354 / 364

页数：11

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