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Real world efficacy and toxicity of consolidation durvalumab following chemoradiotherapy in older Australian patients with unresectable stage III non-small cell lung cancer.
Stevens, Samuel; Nindra, Udit; Shahnam, Adel; Wei, Joe; Bray, Victoria; Pal, Abhijit; Yip, Po Yee; Linton, Anthony; Blinman, Prunella; Nagrial, Adnan; Lee, Jenny; Boyer, Michael; Kao, Steven.
Afiliación
  • Stevens S; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Department of Medical Oncology, Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Hospital Road, Concord, NSW 2139, Australia; School of Medicine, The Univers
  • Nindra U; Department of Medical Oncology, Liverpool Hospital, Sydney, Cnr Elizabeth and Goulburn Street, Liverpool, NSW 2170, Australia; School of Medicine, University of New South Wales, Level 2, AGSM Building, Gate 11 Botany Street, Kensington, NSW 2052, Australia.
  • Shahnam A; Department of Medical Oncology, Crown Princess Margaret Cancer Centre, Westmead Hospital, Sydney, Cnr Hawkesbury and Darcy Road, Westmead, NSW, Australia, 2145.
  • Wei J; Department of Medical Oncology, Crown Princess Margaret Cancer Centre, Westmead Hospital, Sydney, Cnr Hawkesbury and Darcy Road, Westmead, NSW, Australia, 2145; School of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
  • Bray V; Department of Medical Oncology, Liverpool Hospital, Sydney, Cnr Elizabeth and Goulburn Street, Liverpool, NSW 2170, Australia.
  • Pal A; Department of Medical Oncology, Liverpool Hospital, Sydney, Cnr Elizabeth and Goulburn Street, Liverpool, NSW 2170, Australia; Department of Medical Oncology, Bankstown-Lidcombe Hospital, Sydney, Eldrige Road, Bankstown, NSW 2200, Australia.
  • Yip PY; Department of Medical Oncology, Macarthur Cancer Therapy Centre, Campbelltown Hospital, Sydney, Therry Road, Campbelltown, NSW 2560, Australia.
  • Linton A; Department of Medical Oncology, Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Hospital Road, Concord, NSW 2139, Australia; School of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
  • Blinman P; Department of Medical Oncology, Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Hospital Road, Concord, NSW 2139, Australia; School of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
  • Nagrial A; Department of Medical Oncology, Crown Princess Margaret Cancer Centre, Westmead Hospital, Sydney, Cnr Hawkesbury and Darcy Road, Westmead, NSW, Australia, 2145; Department of Medical Oncology, Blacktown Cancer and Haematology Centre, Blacktown Hospital, Sydney, 18 Blacktown Road, Blacktown, NSW 2148
  • Lee J; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Macquarie Medical School, Macquarie University, Wallumattagal Campus, Macquarie, NSW 2109, Australia.
  • Boyer M; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; School of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
  • Kao S; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; School of Medicine, The University of Sydney, Camperdown, NSW 2006, Australia.
J Geriatr Oncol ; 15(2): 101705, 2024 03.
Article en En | MEDLINE | ID: mdl-38290173
ABSTRACT

INTRODUCTION:

Consolidation durvalumab following platinum-based chemoradiotherapy (CRT) significantly improved overall survival for patients with unresectable stage III non-small cell lung cancer (NSCLC) in the PACIFIC trial. However, older patients were underrepresented in PACIFIC, and subsequent analyses suggested trends toward poorer survival and increased toxicity in patients aged ≥70 years old. We assessed the effectiveness and safety of consolidation durvalumab following CRT in older Australian patients with unresectable stage III NSCLC. MATERIALS AND

METHODS:

This retrospective observational study was conducted across seven sites in Sydney, Australia between January 2018 and September 2021. All adult patients with unresectable stage III NSCLC who received platinum-based chemoradiotherapy followed by at least one cycle of consolidation durvalumab were included. Older patients were defined as being ≥70 years old.

RESULTS:

Of 152 patients included in the analysis, 42.8% (n = 67) patients were 70 years or older. Median follow-up was 26.1 months. The two-year overall survival and median PFS was similar between older and younger patients. At two years, 74.8% (95% confidence interval [CI] 65.4-84.2%) of patients <70 years old and 65.2% (95% CI 53.4-77.0%) of older patients were alive (p = 0.07; hazard ratio [HR] 1.64, 95% CI 0.95-2.81). Median progression-free survival (PFS) in patients <70 years was 30.3 months (95% CI 22.2-38.4 months) compared with 26.7 months (95% CI 12.8-40.6 months) in older patients (p = 0.22; HR 1.46, 95% CI 0.80-2.65). Toxicity was also similar, with 11.5% of patients <70 years old and 18.5% of older patients experiencing grade 3-4 adverse events (AEs; p = 0.23); 16.1% and 24.6% of the patients, respectively, discontinued treatment due to toxicity (p = 0.19). Grade 3-4 AEs and treatment discontinuation were associated with Charlson Comorbidity Index >5 (p = 0.011) and chronic obstructive pulmonary disease diagnosis at presentation (p = 0.002), respectively.

DISCUSSION:

Older Australian patients receiving consolidation durvalumab following CRT experienced comparable outcomes to their younger peers. Comorbidity burden may be more important determinants of treatment tolerance than chronological age.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Anticuerpos Monoclonales Tipo de estudio: Observational_studies Límite: Aged / Humans País/Región como asunto: Oceania Idioma: En Revista: J Geriatr Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Anticuerpos Monoclonales Tipo de estudio: Observational_studies Límite: Aged / Humans País/Región como asunto: Oceania Idioma: En Revista: J Geriatr Oncol Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos