Abstract 617P
Background
Durvalumab has been administered to patients with unresectable stage III non-small cell lung cancer (NSCLC). However, it remains unclear whether durvalumab benefits these patients with epidermal growth factor receptor (EGFR) mutation.
Methods
We conducted a retrospective, multicenter study of patients with EGFR mutation who received chemoradiotherapy (CRT) between June 2018 and March 2021. We assessed patient characteristics, efficacy of durvalumab, and its safety before and after targeted therapy.
Results
We collected data on a total of 673 patients, of whom 401 (59.6%) underwent EGFR mutation testing. Fifty-one patients were EGFR positive and 311 were negative. In the EGFR-positive group, there was a higher proportion of females, never smokers, and patients with adenocarcinoma histology. Of the 51 patients in the positive group and 311 in the negative group who received CRT, 45 (88.2%) and 247 (79.4%) received durvalumab, with median progression-free survival of 23.0 (confidence interval (CI): 12.7–NR) and 24.2 (20.3–NR) months in the positive and negative groups, respectively (hazard ratio 1.03; 95% CI: 0.64-1.67). The median OS from durvalumab initiation was not reached (NR) (95% CI: NR–NR) and NR (38.7–NR; HR 0.42; 95% CI: 0.20–0.86; p = 0.08). The main adverse event was pneumonitis (62.2% any grade; 4.4% grade 3 in positive group and 62.3% any grade; 6.9% grade 3 in negative group). No treatment-related deaths were observed. Of the 45 patients in the positive group who received durvalumab, 14 (31.1%) received targeted therapy after durvalumab at data cutoff. One patient discontinued targeted therapy after developing pneumonitis.
Conclusions
In patients with unresectable stage III NSCLC with EGFR mutation, durvalumab after chemoradiotherapy is potentially safe and effective. This may be a suitable treatment sequence for these patients.
Clinical trial identification
(UMIN000048100).
Editorial acknowledgement
Legal entity responsible for the study
Hokkaido Lung Cancer Clinical Study Group (HOT).
Funding
Has not received any funding.
Disclosure
H. Mizugaki: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical Co., Ltd., MSD (Merck Sharp and Dohme), AstraZeneca K.K., Takeda Pharmaceuticals. H. Yokouchi: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Local PI: AstraZeneca, Bristol Myers Squibb, Sanofi, Takeda Pharmaceutical Company Limited, Chugai Pharmaceutical Company Limited, Daiichi Sankyo Company Limited. T. Sumi: Financial Interests, Personal, Invited Speaker: Ono Pharmaceutical Co., Ltd., AstraZeneca, Nippon Boehringer Ingelheim Co., Ltd. S. Konno, S. Oizumi: Financial Interests, Personal, Invited Speaker: AstraZeneca. All other authors have declared no conflicts of interest.