1302P - Treatment outcomes and safety of durvalumab following definitive chemoradiotherapy among patients with stage III NSCLC in Thai populations: A real-world, multi-center observational study

Background

In locally advanced non-small cell lung cancer (LA-NSCLC), durvalumab as consolidation therapy following definitive chemoradiotherapy (CRT) was established as the standard of care. Given the heterogeneity of patients with LA-NSCLC, the present study evaluated the efficacy and safety of durvalumab in a real-world, multi-center observational study.

Methods

111 patients with LA-NSCLC, whose disease had not progressed following CRT and receiving ≥1 dose of durvalumab as part of the expanded access program (EAP) in Thailand and outside EAP were included. In addition to descriptive statistics, the survival probability was determined using the Kaplan-Meier method.

Results

A total of 78 patients from 12 centers participating in the Thailand National Lung Cancer Registry Network were enrolled. The median age was 63 years, 73% were men, 73% had non-squamous and 21.6% of patients with non-squamous histology had epidermal growth factor receptor mutation (EGFRm). Only 14% of patients had been tested for programmed death-ligand 1 (PD-L1) and 54.5% had PD-L1 expression. Most patients (89%) received concurrent CRT and carboplatin/paclitaxel was the most common chemotherapy used. 91.2% received a RT dose ≥60 Gy with a median time of durvalumab initiation from the end of RT being 42 days. Overall, 46 patients (59%) completed the 12-month treatment with a median of 24 cycles. Median follow-up time was 34.5 months (range 7–58) with 2-year PFS and OS of 64.2% and 83.3%, respectively. No significant differences in PFS were detected for EGFRm vs. wild-type EGFR (EGFRwt), but the median PFS was 39 months for EGFRm vs. 27 months for EGFRwt. Immune-related AEs (irAEs) of any grades and grade ≥3 were reported in 41% and 10.3%, respectively. Pneumonitis was the most frequent irAEs (18%), and 6.4% were grade ≥3, leading to discontinuation in 6/78 patients (7.7%).

Conclusions

Durvalumab after definitive CRT showed a promising outcome and was well-tolerated in this real-world study. Although a high prevalence of EGFRm is noted in this region, favorable PFS outcomes were observed regardless of EGFR mutation status.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

AstraZeneca.

Disclosure

P. Sitthideatphaiboon: Financial Interests, Personal, Advisory Board: AstraZeneca, Janssen, Merck, Pfizer, Roche; Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Novartis, Pfizer, Roche, Takeda; Financial Interests, Institutional, Invited Speaker: AstraZeneca, Roche, Merck, Novartis. T. Reungwetwattana: Financial Interests, Personal, Advisory Board, and speaker: AstraZeneca, Pfizer, Roche, MSD, Novartis, BMS, Amgen; Financial Interests, Personal, Advisory Board: Yuhan; Financial Interests, Institutional, Invited Speaker: AstraZeneca, Roche, Novartis, MSD. K. Korphaisarn: Financial Interests, Personal, Invited Speaker: Roche, Amgen, AstraZeneca, MSD; Non-Financial Interests, Principal Investigator: MSD, Roche. T. Suksombooncharoen: Financial Interests, Personal, Invited Speaker: AstraZeneca, Novartis, Bayer, Bristol Myers Squibb, Baxter, Mundipharma (Thailand), Roche, Eli Lilly, Takeda, MSD, Amgen, Janssen; Financial Interests, Personal, Advisory Board: Roche, Novartis; Non-Financial Interests, Principal Investigator: AstraZeneca, Novartis, Roche, MSD. N. Prasongsook: Financial Interests, Personal, Advisory Board: Roche (Thailand), Novartis; Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Pfizer; Financial Interests, Institutional, Advisory Board: Amgen. V. Sriuranpong: Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche, Novartis, Pfizer, Bristol Myers Squibb; Financial Interests, Institutional, Invited Speaker: AstraZeneca, MSD, Takeda, Novartis, Regeneron. All other authors have declared no conflicts of interest.