Clinical outcomes in stage III non-small cell lung cancer patients treated with durvalumab after sequential or concurrent platinum-based chemoradiotherapy – single institute experience Cover

.blurhash-client-img { display: none !important; }

Clinical outcomes in stage III non-small cell lung cancer patients treated with durvalumab after sequential or concurrent platinum-based chemoradiotherapy – single institute experience

Radiology and Oncology

Volume 55 (2021): Issue 4 (December 2021)

By: Martina Vrankar, Karmen Stanic, Stasa Jelercic, Eva Ciric, Ana Lina Vodusek and Jasna But-Hadzic

Open Access

|Nov 2021

Figures & Tables

Progression free survival of patients treated with durvalumab after sequential or concurrent platinum-based chemoradiotherapy.

Progression free survival regarding response after durvalumab completion.

Overall survival of patients treated with durvalumab after sequential or concurrent platinum-based chemoradiotherapy.

Univariate and multivariate analysis of predictors for progression free survival

Variable		Univariate analysis		Multivariate analysis

		HR (95% CI)	p	HR (95 % CI)	p
Age	< 63 years	0.67 (0.35–1.29)	0.231
Age	≥ 63 years
Gender	Male	0.62 (0.32–1.20)	0.156
Gender	Female
ECOG PS	0	0.66 (0.34–1.28)	0.226
ECOG PS	1–2
Stage	IIIA	0.89 (0.54–1.48)	0.663
	IIIB
	IIIC
Histology	Adenocarcinoma	0.84 (0.41–1.70)	0.635
Histology	Squamous Cell
Smoking status	Never	0.59 (0.33–1.07)	0.084	1.72 (0.26–11.00)	0.567
	Ex-smokers
	Smoking at diagnosis
Mutational status	No	0.99 (0.87–1.12)	0.881
Mutational status	KRAS
PD-L1	< 1%	1.03 (0.67–1.59)	0.882
	1%–49%
	> 50%
Time to durvalumab	< 57 days	0.63 (0.32–1.24)	0.186
Time to durvalumab	≥ 57 days
RT dose	< 60 Gy	1.10 (0.43–2.84)	0.838
RT dose	≥ 60 Gy
No of ChT	Up to 3	2.06 (0.94–4.51)	0.069	0.83 (0.23–2.99)	0.783
No of ChT	4–5
ChT	Sequential	1.51 (0.79–2.85)	0.209
ChT	Concurrent
Response after IT	CR	0.066 (0.008–0.518)	0.010	0.067 (0.008–0.535)	0.011
Response after IT	PR/SD
Durvalumab treatment time	< 10.8 months	3.16 (1.62–6.17)	0.001	1.18 (0.227–6.17	0.841
Durvalumab treatment time	≥ 10.8 months

Chemoradiotherapy treatment characteristics

		N = 85 (%)
N of ChT	1	3 (3.5%)
	2	13 (15.3%)
	3	41 (48.2%)
	4	27 (31.8%)
	5	1 (1.2%)
ChT	Gem/cis	79 (92.9%)
	Etop/cis	52 (61.2%)
	Pem/cis	3 (3.5%)
ChT	Induction	82 (96.5%)
	Sequential only	31 (36.5%)
	Concurrent	54 (63.5%)
	Concurrent only	3 (3.5%)
RT dose (Gy)	Median (range)	60 (5 –66)
V20 (Gy)	Median (range)	27.2 (7.0–35.6)
MLD (Gy)	Median (range)	15.7 (4.0–20.2)
PTV (cm³)	Median (range)	416.6 (172.3–1282.6)
Evaluation after ChT-RT	CR	10 (11.8%)
	PR	70 (82.3%)
	SD	5 (5.9 %)
Time between RT-IT (days)	Median (range)	57 (12–99)

Durvalumab treatment characteristics and influence on overall survival

Treatment characteristics		N (%)	P
Time between RT-IT	Median (days)	57 (12–99)	0.689
	< 57
	≥ 57
Treatment time of IT*	Median (months)	10.8 (0.5–12.0)	< 0.001
	< 10.8
	≥ 10.8
Treatment with IT	Completed	41 (48.2%)	0.095
	Early stopped due to AE	25 (29.4%)
	Progression	16 (18.8%)
	Other	3 (3.6%)
Response after IT**	CR	29 (34.1%)	0.213
	PR	11 (12.9%)
	SD	15 (17.6%)
	PD	10 (11.8%)
Progression***	Loco-regional	21 (24.7%)	0.217
	Metastatic	10 (11.7%)
	Metastatic and local	5 (5.9%)
Metastatic spread	CNS	5 (5.9%)	0.101
Metastatic spread	Other	10 (11.7 %)	0.101

Pattern of progression

Progression (N of patients)		Loco-regional only	Metastatic	p
Gender	Male	12	10	0.563
Gender	Female	9	5	0.563
Stage	IIIA	7	3	0.663
	IIIB	11	9
	IIIC	3	3
Histology	Adenocarcinoma	2	9	0.002
	Squamous cell	19	5
	Other	0	1
Mutation	KRAS	0	7	< 0.001
Mutation	No mutation	21	8	< 0.001
PD-L1	< 1%	3	4
	1%–49 %	8	6	0.435
	50 %	10	4

Baseline characteristics of patients treated with durvalumab

		N = 85
Gender	Female	25 (29.4 %)
Gender	Male	60 (70.6 %)
Age	Median (range)
	< 63	63 (36 – 73)
	≥ 63
ECOG PS	0	37 (43.5 %)
	1	46 (54.1 %)
	2	2 (2.4 %)
Smoking history	Never	2 (2.4 %)
	Ex-smokers	35 (41.6 %)
	Smoking at diagnosis	47 (56.0 %)
Histology	Adenocarcinoma	31 (36.5 %)
	Squamous Cell	50 (58.8 %)
	Other	4 (4.7 %)
AJCC 8th Edition Stage	IIIA	26 (30.6%)
	IIIB	48 (56.5 %)
	IIIC	11 (12.9 %)
PD-L1 Expression	< 1%	13 (15.3 %)
	1%-49%	33 (38.8 %)
	> 50%	32 (37.7 %)
	Unavailable	7 (8.2 %)
Mutational status	No mutations	65 (76.5 %)
	KRAS	16 (18.8 %)
	Unavailable	4 (4.7 %)

DOI: https://doi.org/10.2478/raon-2021-0044 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

Journal RSS Feed

Language: English

Page range: 482 - 490

Submitted on: Aug 19, 2021

|

Accepted on: Oct 7, 2021

|

Published on: Nov 19, 2021

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

non-small cell lung cancer,

chemoradiotherapy,

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2021 Martina Vrankar, Karmen Stanic, Stasa Jelercic, Eva Ciric, Ana Lina Vodusek, Jasna But-Hadzic, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Previous article Volume 55 (2021): Issue 4 (December 2021)Next article