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Real-World Outcomes of Subsequent Chemotherapy after Progression Following Chemoradiation and Consolidative Durvalumab Therapy in Locally Advanced Non-small Cell Lung Cancer: An Exploratory Analysis from the CRIMSON Study (HOPE-005).
Kawachi, Hayato; Tamiya, Motohiro; Oya, Yuko; Saito, Go; Taniguchi, Yoshihiko; Matsumoto, Hirotaka; Sato, Yuki; Otsuki, Taiichiro; Suzuki, Hidekazu; Fukuda, Yasushi; Tanaka, Satoshi; Tsukita, Yoko; Uchida, Junji; Sakata, Yoshihiko; Nakatani, Yuki; Shibaki, Ryota; Arai, Daisuke; Okada, Asuka; Hara, Satoshi; Takayama, Koichi; Nishino, Kazumi.
Afiliación
  • Kawachi H; Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan; Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan. Electronic address: kwhat@koto.kpu-m.ac.jp.
  • Tamiya M; Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan.
  • Oya Y; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
  • Saito G; Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan.
  • Taniguchi Y; Department of Internal Medicine, NHO Kinki Chuo Chest Medical Center, Sakai, Osaka, Japan.
  • Matsumoto H; Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan.
  • Sato Y; Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
  • Otsuki T; Department of Respiratory Medicine and Hematology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
  • Suzuki H; Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino, Osaka, Japan.
  • Fukuda Y; Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.
  • Tanaka S; Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Osaka, Japan.
  • Tsukita Y; Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.
  • Uchida J; Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan.
  • Sakata Y; Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Kumamoto, Japan.
  • Nakatani Y; Department of Medical Oncology, Osaka City General Hospital, Osaka, Osaka, Japan.
  • Shibaki R; Internal Medicine III, Wakayama Medical University, Wakayama, Wakayama, Japan.
  • Arai D; Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan.
  • Okada A; Department of Respiratory Medicine, Saiseikai Suita Hospital, Suita, Osaka, Japan.
  • Hara S; Department of Respiratory Medicine, Itami City Hospital, Itami, Japan.
  • Takayama K; Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan.
  • Nishino K; Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan.
Clin Lung Cancer ; 25(7): 643-652.e4, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39138106
ABSTRACT

BACKGROUND:

The optimal subsequent treatment strategy for locally advanced non-small cell lung cancer (LA-NSCLC) after chemoradiotherapy (CRT) and consolidative durvalumab therapy remains unknown. We aimed to determine the optimal subsequent treatment strategy for this clinical population. MATERIALS AND

METHODS:

We retrospectively enrolled 523 consecutive patients with LA-NSCLC treated with CRT and analyzed the treatment outcomes of subsequent therapy after progression following CRT and consolidative durvalumab therapy. Patients who received tyrosine kinase inhibitors as subsequent therapy were excluded.

RESULTS:

Out of 122 patients who received subsequent chemotherapy, 55% underwent platinum-based, 25% non-platinum-based, and 20% immune checkpoint inhibitor (ICI)-containing therapies. In the platinum-based group, patients with a durvalumab-progression-free survival (Dur-PFS) ≥ 1 year had a significantly longer median subsequent therapy-PFS (SubTx-PFS) than those with Dur-PFS < 1 year (13.2 months vs. 4.7 months; hazard ratio, 0.45; 95% confidence interval, 0.21-0.97; P = .04). Furthermore, among patients receiving non-platinum-based chemotherapy, the median SubTx-PFS was longer in the combined with angiogenesis inhibitor group than in the without group, although the difference was not statistically significant. No significant difference of SubTx-PFS was observed between the reason for durvalumab discontinuation and the outcomes of ICI-containing therapy.

CONCLUSION:

In clinical practice, platinum-based chemotherapy rechallenge is frequently employed following progression subsequent to CRT and consolidative durvalumab therapy for LA-NSCLC. Optimal treatment strategies may consider Dur-PFS and angiogenesis inhibitor feasibility. Further research is warranted to identify clinical biomarkers that can help identify patients who would benefit from ICI rechallenge.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Progresión de la Enfermedad / Quimioradioterapia / Neoplasias Pulmonares / Anticuerpos Monoclonales Límite: Adult / Aged / 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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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Progresión de la Enfermedad / Quimioradioterapia / Neoplasias Pulmonares / Anticuerpos Monoclonales Límite: Adult / Aged / 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