ESTRO 2025 - Abstract Book

S1374

Clinical - Lung

ESTRO 2025

2802

Digital Poster Multi-centre real-world experience with adjuvant durvalumab after chemoradiotherapy in Non-small Cell Lung Cancer: five-year real-world outcomes Femi Adeoye 1,2 , Nida Jaffar 2 , Jufen Zhang 3 , Gulshad Begum 1,2 , Mohammad Rafiqul Islam 2,4 1 Oncology Department, Basildon University Hospital, Basildon, United Kingdom. 2 Oncology Department, Southend University Hospital, Southend-on-Sea, United Kingdom. 3 School of Medicine, Anglia Ruskin University, Chelmsford, United Kingdom. 4 Oncology Department, Broomfield Hospital, Chelmsford, United Kingdom Purpose/Objective: Since the phase III PACIFIC trial established the overall survival and progression-free survival benefits of consolidation durvalumab in patients with locally advanced, unresectable, stage III Non-small Cell Lung Cancer after definitive chemoradiation therapy, it has become the standard of care in this setting. The objective of this study was to describe the characteristics and clinical outcomes of this group of patients receiving durvalumab after chemoradiotherapy in a real-world clinical setting. Material/Methods: This was a retrospective observational study involving patients with locally advanced, unresectable NSCLC treated with maintenance durvalumab across three hospitals in the United Kingdom between March 2019 and May 2024. Data was collected retrospectively from Electronic Medical Record systems. The variables obtained included patient demographics, tumour characteristics, treatments received, benefits and tolerance patterns. Progression free survival and overall survival were calculated using the Kaplan-Meier method. Results: A total of 67 patients who had consolidation durvalumab across these three centres were included in this study, with 14 patients (20.9%) still undergoing immunotherapy at data cut-off date. After a median follow-up duration of 16 months (range 0-54), 50 patients (74.6%) were alive and 17 (25.4%) had progression of disease. Overall, in comparison with the patients who were recruited into the PACIFIC trial, 1 our patients were older, frailer and had more advanced disease with a median age of 68 years and about two-thirds (65.7%) of them were at least 65 years of age (range 38-82 years). The most common radiotherapy dose fractionation was 55Gy in 20 daily fractions (56.7%). All patients completed radiotherapy without significant side effects or interruptions, and a vast majority (88.1%) commenced durvalumab within 42 days of completing Chemoradiotherapy. The median number of durvalumab doses administered was 18 (range 1-27). The 24-month progression-free survival and overall survival were 66% (95% CI 51-77) and 75% (95% CI 61-85) respectively. Subgroup analyses showed better outcomes in patients with non-squamous cell cancers than those with squamous cell cancers and in those with PD-L1 ≥50% than PD-L1 <50%. While, the most common immune-related adverse event was thyroiditis (13.4%), grade 3 or 4 toxicities leading to durvalumab discontinuation was observed in 12 patients (17.9%), with pneumonitis being the commonest 7(10.4%). Conclusion: Our real-world experience indicates that adjuvant durvalumab showed comparable progression-free survival and overall survival benefits, and was well tolerated even though the patients in this study had relatively worse baseline clinical and tumour characteristics compared to those who participated in the PACIFIC trial.

Keywords: Durvalumab, Chemoradiotherapy, Lung Cancers

References: 1. Spigel DR, Faivre-Finn C, Gray JE, et al. Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. J Clin Oncol. 2022 Apr 20;40(12):1301-1311.