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Durvalumab Consolidation After Chemoradiotherapy in Elderly Patients With Unresectable Stage III NSCLC: A Real-World Multicenter Study.
Park, Ji Eun; Hong, Kyung Soo; Choi, Sun Ha; Lee, Shin Yup; Shin, Kyeong-Cheol; Jang, Jong Geol; Kwon, Yong Shik; Park, Sun Hyo; Choi, Keum-Ju; Jung, Chi Young; Eom, Jung Seop; Kim, Saerom; Seol, Hee Yun; Kim, Jehun; Kim, Insu; Park, Jin Han; Kim, Tae Hoon; Ahn, June Hong.
Afiliación
  • Park JE; Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
  • Hong KS; Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
  • Choi SH; Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
  • Lee SY; Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
  • Shin KC; Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
  • Jang JG; Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
  • Kwon YS; Department of Internal Medicine, School of Medicine, Keimyung University, Busan, Republic of Korea.
  • Park SH; Department of Internal Medicine, School of Medicine, Keimyung University, Busan, Republic of Korea.
  • Choi KJ; Department of Internal Medicine, College of Medicine, Daegu Catholic University, Daegu, Republic of Korea.
  • Jung CY; Department of Internal Medicine, College of Medicine, Daegu Catholic University, Daegu, Republic of Korea.
  • Eom JS; Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Republic of Korea.
  • Kim S; Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Republic of Korea.
  • Seol HY; Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Republic of Korea.
  • Kim J; Department of Internal Medicine, College of Medicine, Kosin University College of Medicine, Busan, Republic of Korea.
  • Kim I; Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea.
  • Park JH; Department of Internal Medicine, College of Medicine, Inje University, Busan, Republic of Korea.
  • Kim TH; Department of Internal Medicine, School of Medicine, Gyeongsang National University, Changwon, Republic of Korea.
  • Ahn JH; Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea. Electronic address: fireajh@gmail.com.
Clin Lung Cancer ; 25(4): 354-364, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38503590
ABSTRACT

BACKGROUND:

The PACIFIC trial demonstrated survival benefit of durvalumab after concurrent chemoradiotherapy (CCRT) in unresectable stage III non-small-cell lung cancer. Data on the effectiveness and safety of durvalumab in elderly patients is lacking.

METHODS:

This retrospective study was conducted between September 2017 and September 2022. Progression-free survival (PFS), overall survival (OS), recurrence patterns, first subsequent treatment after recurrence, factors associated with survival outcomes, and adverse events (AEs) were compared.

RESULTS:

Of the 286 patients, 120 (42.0%) were ≥ 70 years and 166 (58.0%) were < 70 years. The median PFS (17.7 vs. 19.4 months; P = .43) and median OS (35.7 months vs. not reached; P = .13) were similar between 2 groups. Proportion of patients who completed durvalumab was lower in elderly patients (27.5% vs. 39.2%; P = .040). In elderly patients, ECOG PS 0 or 1 was associated with better PFS, and being male and having received a cisplatin-based regimen during CCRT were factors associated with better and worse OS, respectively. In patients aged < 70 years, a PD-L1 ≥ 50% was associated with improved PFS and OS. Elderly patients experienced more treatment-related AEs, grade 3/4 AEs, permanent discontinuation of durvalumab, and treatment-related deaths. Among the AEs leading to permanent discontinuation or death, pulmonary AE was significantly more common in elderly patients.

CONCLUSION:

Durvalumab demonstrated similar outcomes in elderly compared to younger patients. However, AEs were more common in elderly patients. Thus, judicious selection of patients and chemotherapy regimens, coupled with careful AE monitoring, are important factors for ensuring optimal durvalumab treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Quimioradioterapia / Neoplasias Pulmonares / Anticuerpos Monoclonales / Estadificación de Neoplasias Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Quimioradioterapia / Neoplasias Pulmonares / Anticuerpos Monoclonales / Estadificación de Neoplasias Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos