Pneumonitis and Survival Outcomes in Patients With NSCLC Treated With Durvalumab

The following article features coverage from the IASLC North America Conference on Lung Cancer 2019 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

In 2017, the phase 3 PACIFIC trial found that the PD-1/PD-L1 inhibitor durvalumab, an immunotherapy drug, was effective in treating locally advanced non-small cell lung cancer (LA-NSCLC) in patients who had previously received chemoradiotherapy.¹ Some patients in trial, however, developed pneumonitis at increased rates. In a presentation at the International Association for the Study of Lung Cancer (IASLC) 2019 North America Conference on Lung Cancer (NACLC 2019) in Chicago, Illinois, researchers examined real-life outcomes with the PACIFIC paradigm and found that the higher incidence of pneumonitis did not affect overall survival.²

Tim Sita, MD, PhD, of Northwestern University Feinberg School of Medicine in Chicago, Illinois, and colleagues analyzed outcomes of 36 LA-NSCLC patients, 89% of whom had stage III disease, 3% with stage IIB, and 8% with recurrent disease. Of these patients, 25.5% developed pneumonitis 3 months after treatment with durvalumab and 29% had pneumonitis 6 months after treatment. There were no grade 4 or 5 events, but 2 patients developed grade 3 pneumonitis. The median time to development of pneumonitis after radiotherapy treatment was 71 days (range: 29-270). Patients were treated for pneumonitis with prednisone (median dose 60 mg) and had durvalumab treatment postponed for a median 4.5 weeks (range: 2-8). Among the 70% of patients who were put back on the immunotherapy drug after pneumonitis symptoms subsided, 14% had a recurrence.   

Compared to previous study data, the patients fared well, with similar overall survival rates. At 18 months, overall survival was 86.4%, and progression-free survival at 9 months was 66% for patients who developed pneumonitis compared to 70% for those who did not. “Development of pneumonitis did not impact outcomes,” the abstract authors wrote. 

Read more of Cancer Therapy Advisor‘s coverage of the IASLC NACLC 2019 meeting by visiting the conference page.

References

1. AstraZeneca presents superior progression-free survival for Imfinzi in the PACIFIC trial of patients with locally-advanced unresectable lung cancer at ESMO 2017 Congress [news release]. https://www.astrazeneca.com/media-centre/press-releases/2017/astrazeneca-presents-superior-progression-free-survival-for-imfinzi-in-the-pacific-trial-of-patients-with-locally-advanced-unresectable-lung-cancer-at-esmo-2017-congress-08092017.html. Published September 8, 2017. Accessed October 11, 2019.
2. Sita T, Hassanzadeh C, Savoor R, et al. Multi-institutional study of pneumonitis after treatment with durvalumab and chemoradiotherapy for non-small cell lung cancer. Presented at: International Association for the Study of Lung Cancer (IASLC) 2019 North America Conference on Lung Cancer (NACLC 2019); October 10-12, 2019: Chicago, Illinois. Abstract OA03.03