Abstract 127P
Background
Several real-world experiences have been reported safety and effectiveness of Durvalumab after concurrent or sequential chemo-radiotherapy (ChT-RT) in lLA-NSCLC patients. There is a lack of data after sequential ChT-hypofractionated RT. In single arm phase II trial (NCT05291780) we assessed local control (LC) and safety of stereotactic ablative radiotherapy (SAbR) in unresectable LA-NSCLC patients unfit for concurrent ChT-RT (1). Here we report clinical outcomes of SAbR in LA-NSCLC patients treated with radical-intent based on PACIFIC trial.
Methods
Between December 31, 2015 and June 30, 2022 71 LA-NSCLC patients were enrolled. 40 (56%) fit patients received neoadjuvant ChT and 15 (37%) received Durvalumab. The tumor volume included primary tumor (T) and any regionally positive node/s (N). The co-primary study endpoints were LC and safety.
Results
The median age was 71 years (range, 52–78). Histology was adenocarcinoma (ADC) and squamous cell carcinoma (SCC) and in 9 (60%) and 6 (40%), respectively. The stage was IIIA, IIIB and IIIC in 7 (47%), 5 (33%) and 3 (20%) patients, respectively. Median prescribed dose was 45 Gy (range, 40–50) and 40 Gy (35–50) in 5 daily fractions to T and N, respectively. After a median follow-up of 16 months (range, 6–62), 4 (27%) patients had experienced local recurrence (LR) at a median time of 13 months (range, 7–34). The median LR-free survival (FS) was 34 months (95% CI, 14 to 34). The 1-, 2- and 4-year LR-FS rates were 92 ± 8%, 72 ± 14% and 48 ± 22%, respectively. At last follow-up, 23 (58%) patients were alive. Median overall survival (OS) was 50 months (95% CI, 31–55). The 1, 2, and 4-year OS rates were 92 ± 5%, 70 ± 8% and 51 ± 9%, respectively. 7 patients had disease recurrence, 4 and 3 during and after completion of Durvalumab. 2(13%) discontinued Durvalumab due to G3 toxicity.
Conclusions
SABR and immunotherapy can be the backbone of patients unfit to concurrent ChT-RT. Our early outcomes would suggest the feasibility of using this approach in LA-NSCLC patients unfit for concurrent ChT-RT.
Int J Radiat Oncol Biol Phys. 2022 Oct 24;S0360–3016(22)03459–9. doi: 10.1016/j.ijrobp.2022.10.025.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.