KEY TAKEAWAYS
- The study aimed to assess durvalumab’s efficacy and safety post-CCRT in elderly stage III NSCLC patients.
- The results showed similar outcomes in elderly and younger patients with durvalumab, albeit with higher AEs in the elderly.
The PACIFIC trial highlighted durvalumab’s survival advantage post-concurrent chemoradiotherapy (CCRT) for unresectable stage III non-small cell lung cancer (NSCLC) but lacked data on elderly efficacy.
Ji Eun Park and the team aimed to assess the efficacy and safety of durvalumab in elderly patients with unresectable stage III NSCLC.
The study was conducted between September 2017 and September 2022 and compared progression-free survival (PFS), overall survival (OS), recurrence patterns, first subsequent treatment after recurrence, factors associated with survival outcomes, and adverse events (AEs).
Among the 286 patients, 120 (42.0%) were aged ≥70 years, while 166 (58.0%) were <70 years. Median PFS (17.7 vs. 19.4 months; P= 0.43) and median OS (35.7 months vs. not reached; P= 0.13) were similar between the two age groups. However, fewer elderly patients completed durvalumab treatment than younger patients (27.5% vs. 39.2%; P = 0.040).
In elderly patients, better PFS was associated with ECOG PS 0 or 1, while in patients aged <70 years, higher PD-L1 expression (≥50%) correlated with improved PFS and OS. Elderly patients experienced more treatment-related AEs (TRAEs), including grade 3/4 AEs, permanent discontinuation of durvalumab, and treatment-related deaths. Notably, pulmonary AEs leading to permanent discontinuation or death were significantly more common in elderly patients.
The study found that while durvalumab yielded similar outcomes in elderly and younger patients, AEs were more prevalent among the elderly. Thus, careful patient selection and vigilant AEs monitoring are vital for optimizing treatment. No funding-related information was available.
Source: https://www.clinical-lung-cancer.com/article/S1525-7304(24)00017-2/abstract#%20
Park JE, Hong KS, Choi SH, et al. (2024) ‘’Durvalumab consolidation after chemoradiotherapy in elderly patients with unresectable stage III NSCLC: A real-world multicenter study.’’ DOI: https://doi.org/10.1016/j.cllc.2024.02.006.
