Durvalumab Reduces Mortality Rate in Stage III Lung Cancer Patients

A recent study found that durvalumab extended survival rates in some patients with stage III, unresectable non–small-cell lung cancer (NSCLC).

Researchers randomly assigned 709 NSCLC patients who did not have disease progression after concurrent chemoradiotherapy to receive durvalumab (n = 473) intravenously, at a dose of 10 mg per kilogram of body weight, or matching placebo (n = 236) every two weeks for up to 12 months. 

After two years, the survival rate in the durvalumab group was 66.3% (95% confidence interval [CI], 61.7 to 70.4) and 55.6% (95% CI, 48.9 to 61.8) in the placebo group (two-sided P = 0.005). Median progression-free survival rates were 17.2 months for the durvalumab group and 5.6 months in the placebo group (stratified hazard ratio for disease progression or death, 0.51; 95% CI, 0.41 to 0.63). In the durvalumab cohort, median time to death or distant metastasis was 28.3 months, compared to 16.2 months in the placebo cohort (stratified hazard ratio, 0.53; 95% CI, 0.41 to 0.68). Grade 3 or 4 adverse events of any cause occurred in 30.5% of the durvalumab patients and 26.1% of the placebo patients—15.4% and 9.8% of patients, respectively, dropped out of the trial due to adverse events. 

After the intervention, placebo patients were more likely to receive subsequent anticancer therapy than those who had received durvalumab (54% vs 41%). Thirty percent (n = 71) of the placebo group and 26.9% (n = 128) went on to receive cytotoxic chemotherapy; 22.4% (n = 53) and 8% (n = 38) patients, respectively, received additional immunotherapy; 13.1% (n = 31) and 9.9% (n = 47) patients, respectively, received non—immunotherapy-based targeted therapy; and 23.6% (n = 56) of placebo patients and 17.2% (n = 82) of durvalumab patients received radiotherapy. 

One of the study’s limitations is researchers had incomplete data on previous treatment, so causality for some adverse effects or risk factors could not be determined. 

The study authors concluded that the study “showed a survival advantage with durvalumab therapy after concurrent chemoradiation therapy in patients with stage III, unresectable NSCLC.” 

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Source: NEJM