Patients with unresectable stage 3 non-small cell lung cancer (NSCLC) without disease progression after chemoradiotherapy (CRT) appeared to have a long-term overall survival (OS) benefit with durvalumab compared with patients who received placebo, according to 3-year follow-up data from the phase 3 PACIFIC trial published in the Journal of Thoracic Oncology.

Patients enrolled on the PACIFIC trial (ClinicalTrials.gov Identifier: NCT02125461) were randomized in a 2:1 fashion to received either durvalumab 10 mg/kg intravenously every 2 weeks or placebo for up to 12 months.

Overall, 713 patients were randomly assigned to a treatment arm, but 709 were ultimately treated, which included 473 patients on the durvalumab arm and 236 on the placebo arm. Patients were followed for a median of 33.3 months, and 44.1% of patients on the durvalumab arm and 56.5% on the placebo arm died by January 31, 2019.

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Previously, it was reported that durvalumab showed improved OS (hazard ratio [HR], 0.68; 95% CI, 0.53–0.87; P =.00251), and that improvement in OS remained for the updated analysis (HR, 0.69; 95% CI, 0.55–0.86).

The updated analysis also showed that patients on the durvalumab arm had a median OS that was not yet reached, while patients on the placebo arm had a median OS of 29.1 months. Patients on the durvalumab arm had a 57.0% OS rate at 36 months and patients on the placebo arm had a 43.5% OS rate.

No additional safety data were collected for this analysis. Secondary end points, such as the time to first subsequent therapy, showed improvements with durvalumab that were consistent with previous analyses.

“Overall, the findings of this analysis underscore the long-term survival benefit with durvalumab following CRT and further establish the PACIFIC regimen as the standard of care in patients with unresectable, stage 3 NSCLC who do not progress on CRT,” the study authors wrote.

Disclosure: Some of the study authors disclosed financial relationships with pharmaceutical companies. For a full list of disclosures, please refer to the original paper.

Reference

Gray JE, Villegas A, Daniel D, et al. Brief report: Three-year overall survival with durvalumab after chemoradiotherapy in stage III NSCLC – Update from PACIFIC [published online October 14, 2019. J Thorac Oncol. doi: 10.1016/j.jtho.2019.10.002