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Poster Display session

123P - Second progression-free survival (PFS2) after first progression in patients receiving PACIFIC regimen: An exploratory analysis of the Blue Sky observational study


31 Mar 2023


Poster Display session


Andrea Riccardo Filippi


Journal of Thoracic Oncology (2023) 18 (4S): S106-S115.


A.R.R. Filippi1, J. Saddi2, F. Agustoni3, G. Galli2, S. La Mattina2, G. Facheris4, S. Arcangeli5, D.L. Cortinovis6, G. Piperno7, M.A. Zerella7, A.G. Becchetti8, L. Falcinelli9, G. Stella10, C. Bortolotto10, A. Ferrari3, P. Pedrazzoli3, L. Preda10, P. Borghetti11

Author affiliations

  • 1 Pavia/IT
  • 2 Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, Pavia/IT
  • 3 Fondazione IRCCS Policlinico San Matteo, Pavia/IT
  • 4 Radiotherapy Unit, Brescia/IT
  • 5 Università degli Studi di Milano-Bicocca, Milano/IT
  • 6 Fondazione IRCCS San Gerardo dei Tintori, Monza/IT
  • 7 European Institute of Oncology, Milan/IT
  • 8 University of Perugia, Perugia/IT
  • 9 Perugia General Hospital,, Perugia/IT
  • 10 University of Pavia, Pavia/IT
  • 11 Azienda Ospedaliera Spedali Civili di Brescia, Brescia/IT


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Abstract 123P


The Blue Sky Radiomic trial is a multicenter, observational, retrospective, and prospective study started in 2020, with a target sample size of 100 patients with unresectable stage III A-C NSCLC treated with the PACIFIC regimen (clinicaltrial.gov identifier: NCT04364776, active, recruiting). We here report an exploratory analysis of PFS2 after the first progression.


All patients were deemed unresectable by MTB and had PD-L1-positive (>1%) tumors, with at least stable disease, and receiving one durvalumab dose after CRT; 93/100 pts were evaluable, with 56 recorded events (6 deaths and 50 progressions). PFS2 was calculated for these 50 pts from the date of first to second progression or death (Kaplan-Meier).


At a median follow-up time of 18 months, the median PFS of the entire cohort was 23.2 months (2.10–47.63). Median OS was not reached. Among patients experiencing a first PD (n = 50), 9 pts (18%) relapsed within the first 3 months from durvalumab start, 10 (20%) between 3 and 6, and 31 (62%) after 6 months. The pattern of relapse was as follows: 16 local recurrences (32%), 17 distant progressions (34%), and 17 both (34%), respectively. Forty-one/50 (82%) patients did receive an active treatment at the first progression: 22 pts systemic therapy (53.6%, 9 pts a platinum-based doublet, 11 mono-CT, 1 IO, and 1 TKI); 10 RT alone (24.4%); 6 CT plus local treatment (14.6%), and 3 metastasectomies alone (7.4%). With a median follow-up of 5.33 months (1.07–32.43) from the first PD, we recorded 29 deaths. Ten pts are alive without progression, and 11 are alive with progressive disease. Median PFS2 was 7.23 months (1.03–42), and median OS was 15.5 months (1.07–46.17), respectively.


This exploratory analysis suggests that most progressing patients can receive subsequent therapy at the time of first progression following CRT plus durvalumab in a real-world setting. The median PFS2 of around 7 months could be used as a reference for the design of future trials.

Clinical trial identification


Legal entity responsible for the study

Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.


Fondazione IRCCS Policlinico San Matteo, Ricerca Corrente 2019.


A.R.R. Filippi: Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca, Roche; Financial Interests, Personal, Advisory Board: AstraZeneca, Roche; Financial Interests, Institutional, Sponsor/Funding: MSD, Roche, AstraZeneca; Financial Interests, Personal, Speaker's Bureau: Ipsen. G. Piperno: Financial Interests, Personal, Speaker's Bureau: AstraZeneca. All other authors have declared no conflicts of interest.

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