Durvalumab Consolidation After Chemoradiotherapy in Elderly Patients With Unresectable Stage III NSCLC : A Real-World Multicenter Study
Copyright © 2024 Elsevier Inc. All rights reserved..
BACKGROUND: The PACIFIC trial demonstrated survival benefit of durvalumab after concurrent chemoradiotherapy (CCRT) in unresectable stage III non-small-cell lung cancer. Data on the effectiveness and safety of durvalumab in elderly patients is lacking.
METHODS: This retrospective study was conducted between September 2017 and September 2022. Progression-free survival (PFS), overall survival (OS), recurrence patterns, first subsequent treatment after recurrence, factors associated with survival outcomes, and adverse events (AEs) were compared.
RESULTS: Of the 286 patients, 120 (42.0%) were ≥ 70 years and 166 (58.0%) were < 70 years. The median PFS (17.7 vs. 19.4 months; P = .43) and median OS (35.7 months vs. not reached; P = .13) were similar between 2 groups. Proportion of patients who completed durvalumab was lower in elderly patients (27.5% vs. 39.2%; P = .040). In elderly patients, ECOG PS 0 or 1 was associated with better PFS, and being male and having received a cisplatin-based regimen during CCRT were factors associated with better and worse OS, respectively. In patients aged < 70 years, a PD-L1 ≥ 50% was associated with improved PFS and OS. Elderly patients experienced more treatment-related AEs, grade 3/4 AEs, permanent discontinuation of durvalumab, and treatment-related deaths. Among the AEs leading to permanent discontinuation or death, pulmonary AE was significantly more common in elderly patients.
CONCLUSION: Durvalumab demonstrated similar outcomes in elderly compared to younger patients. However, AEs were more common in elderly patients. Thus, judicious selection of patients and chemotherapy regimens, coupled with careful AE monitoring, are important factors for ensuring optimal durvalumab treatment.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Clinical lung cancer - (2024) vom: 17. Feb. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Park, Ji Eun [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 19.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1016/j.cllc.2024.02.006 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369931947 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369931947 | ||
| 003 | DE-627 | ||
| 005 | 20240320235251.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240320s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.cllc.2024.02.006 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1337.xml |
| 035 | |a (DE-627)NLM369931947 | ||
| 035 | |a (NLM)38503590 | ||
| 035 | |a (PII)S1525-7304(24)00017-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Park, Ji Eun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Durvalumab Consolidation After Chemoradiotherapy in Elderly Patients With Unresectable Stage III NSCLC |b A Real-World Multicenter Study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 19.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The PACIFIC trial demonstrated survival benefit of durvalumab after concurrent chemoradiotherapy (CCRT) in unresectable stage III non-small-cell lung cancer. Data on the effectiveness and safety of durvalumab in elderly patients is lacking | ||
| 520 | |a METHODS: This retrospective study was conducted between September 2017 and September 2022. Progression-free survival (PFS), overall survival (OS), recurrence patterns, first subsequent treatment after recurrence, factors associated with survival outcomes, and adverse events (AEs) were compared | ||
| 520 | |a RESULTS: Of the 286 patients, 120 (42.0%) were ≥ 70 years and 166 (58.0%) were < 70 years. The median PFS (17.7 vs. 19.4 months; P = .43) and median OS (35.7 months vs. not reached; P = .13) were similar between 2 groups. Proportion of patients who completed durvalumab was lower in elderly patients (27.5% vs. 39.2%; P = .040). In elderly patients, ECOG PS 0 or 1 was associated with better PFS, and being male and having received a cisplatin-based regimen during CCRT were factors associated with better and worse OS, respectively. In patients aged < 70 years, a PD-L1 ≥ 50% was associated with improved PFS and OS. Elderly patients experienced more treatment-related AEs, grade 3/4 AEs, permanent discontinuation of durvalumab, and treatment-related deaths. Among the AEs leading to permanent discontinuation or death, pulmonary AE was significantly more common in elderly patients | ||
| 520 | |a CONCLUSION: Durvalumab demonstrated similar outcomes in elderly compared to younger patients. However, AEs were more common in elderly patients. Thus, judicious selection of patients and chemotherapy regimens, coupled with careful AE monitoring, are important factors for ensuring optimal durvalumab treatment | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Non-small cell lung cancer | |
| 650 | 4 | |a Real-world data | |
| 700 | 1 | |a Hong, Kyung Soo |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Sun Ha |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Shin Yup |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Kyeong-Cheol |e verfasserin |4 aut | |
| 700 | 1 | |a Jang, Jong Geol |e verfasserin |4 aut | |
| 700 | 1 | |a Kwon, Yong Shik |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Sun Hyo |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Keum-Ju |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Chi Young |e verfasserin |4 aut | |
| 700 | 1 | |a Eom, Jung Seop |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Saerom |e verfasserin |4 aut | |
| 700 | 1 | |a Seol, Hee Yun |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jehun |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Insu |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Jin Han |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Tae Hoon |e verfasserin |4 aut | |
| 700 | 1 | |a Ahn, June Hong |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical lung cancer |d 1999 |g (2024) vom: 17. Feb. |w (DE-627)NLM143155229 |x 1938-0690 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:17 |g month:02 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.cllc.2024.02.006 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 17 |c 02 | ||