Long-term outcomes of durvalumab after chemoradiotherapy in locally advanced non-small cell lung cancer in Russia-Reference-Cited by-同舟云学术

Long-term outcomes of durvalumab after chemoradiotherapy in locally advanced non-small cell lung cancer in Russia

Published:2024-07-24 Issue:10 Volume: Page:37-44
ISSN:2658-5790
Container-title:Meditsinskiy sovet = Medical Council
language:
Short-container-title:Medicinskij sovet

Author:

Yudin D. I.¹^ORCID,Laktionov К. К.²^ORCID,Moiseenko F. V.³^ORCID,Ponomarenko D. M.⁴^ORCID,Сhernykh M. V.⁵^ORCID,Chubenko V. A.⁶^ORCID,Levchenko N. V.⁶^ORCID,Kozlov V. V.⁷^ORCID,Stepanova E. О.⁶^ORCID,Khagazheeva M. N.¹^ORCID,Yukalchuk D. Yu.⁸^ORCID

Affiliation:

1. Blokhin National Medical Research Center of Oncology

2. Blokhin National Medical Research Center of Oncology; Pirogov Russian National Research Medical University

3. St Petersburg Clinical Research and Practice Centre for Specialized Care (Oncological); Petrov Research Institute of Oncology; North-Western State Medical University named after I.I. Mechnikov

4. Irkutsk Regional Oncology Dispensary; Irkutsk State Medical University; Irkutsk State Medical Academy of Postgraduate Education

5. Blokhin National Medical Research Center of Oncology; Sechenov First Moscow State Medical University (Sechenov University)

6. St Petersburg Clinical Research and Practice Centre for Specialized Care (Oncological)

7. Novosibirsk Regional Oncology Dispensary; Novosibirsk State Medical University

8. Irkutsk Regional Oncology Dispensary

Abstract

Introduction. The results of the PACIFIC trial have changed the standards of care for the patients with unresectable stage III nonsmall cell lung cancer (NSCLC). However, many patients in our clinical practice do not meet the inclusion criteria of PACIFIC trial.Aim. To evaluate the long-term outcomes for this approach in real clinical practice in Russia.Materials and мethods. This real-world observational retrospective multicenter study analyzed clinical outcomes in 100 patients with unresectable stage III NSCLC after concurrent or sequential chemoradiotherapy (CRT). The overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meyer method. Multivariate subgroups analysis was performed as well. The median follow-up time was 22.7 months.Results. There were 96% patients with ECOG/WHO performance status 0 or 1 in our study. Most of the patients were treated by sequential CRT (76%). Median time of durvalumab start from the end of CRT was 34 days. Patients received durvalumab for a median 10 months. The estimated median progression-free survival (PFS) and overall survival (OS) were 14.3 months (11.8–16.7, 95% CI) and 29 months (18.7–39.2, 95% CI), respectively. The estimated 1-year and 2-year rates for OS and for PFS were 90.4%, 62.8% and 59.1%, 35%, respectively. In multivariate analysis, a smoking history (HR = 0.21 (0.10–0.45; 95% CI) and concurrent CRT (HR = 0.3 (0.12–0.74; 95%CI) were associated with better PFS. The smoking history was significantly associated with a better OS (HR = 0.29 (0.10–0.76; 95% CI)) as well.Conclusions. There is a difference between the real-world outcomes for patients with unresectable stage III NSCLC in Russia and the PACIFIC trial. Sequential CRT is the most frequent treatment option for locally advanced unresectable NSCLC in Russia, and estimated OS and PFS are shorter than in the PACIFIC clinical trial. A paradigm shift in chemoradiotherapy to the concurrent and personalized approach could change the current situation.

Publisher

Remedium, Ltd.

Reference22 articles.

1. Kaprin AD, Starinskii VV, Shakhzadova AO (red.). Sostoyanie onkologicheskoi pomoshchi naseleniyu Rossii v 2022 godu. M.: MNIOI im. P.A. Gertsena − filial FGBU «NMITs radiologii» Minzdrava Rossii; 2022. 239 s.

2. Casal-Mouriño A, Ruano-Ravina A, Lorenzo-González M, Rodríguez-Martínez Á, Giraldo-Osorio A, Varela-Lema L et al. Epidemiology of stage III lung cancer: frequency, diagnostic characteristics, and survival. Transl Lung Cancer Res. 2021;10(1):506–518. https://doi.org/10.21037/tlcr.2020.03.40.

3. Provencio M, Carcereny E, Rodríguez-Abreu D, López-Castro R, Guirado M, Camps C et al. Lung cancer in Spain: information from the Thoracic Tumors Registry (TTR study). Transl Lung Cancer Res. 2019;8(4):461–475. https://doi.org/10.21037/tlcr.2019.08.05.

4. Walters S, Maringe C, Coleman MP, Peake MD, Butler J, Young N et al. Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004–2007. Thorax. 2013;68(6):551–564. https://doi.org/10.1136/thoraxjnl-2012-202297.

5. Petrella F, Rizzo S, Attili I, Passaro A, Zilli T, Martucci F et al. Stage III NonSmall-Cell Lung Cancer: An Overview of Treatment Options. Curr Oncol. 2023;30(3):3160–3175. https://doi.org/10.3390/curroncol30030239.