William Osler Health System, Brampton/Toronto, and University of Toronto, Toronto, ON.
R.S. McLaughlin Durham Regional Cancer Centre, Oshawa, and Queen's University, Kingston, ON.
Curr Oncol. 2019 Feb;26(1):37-42. doi: 10.3747/co.25.4096. Epub 2019 Feb 1.
For more than a decade, there has been no improvement in outcomes for patients with unresectable locally advanced (la) non-small-cell lung cancer (nsclc). The standard treatment in that setting is definitive concurrent chemotherapy and radiation (ccrt). Although the intent of treatment is curative, most patients rapidly progress, and their prognosis is poor, with a 5-year overall survival (os) rate in the 15%-25% range. Those patients therefore represent a critical unmet need, warranting expedited approval of, and access to, new treatments that can improve outcomes. The pacific trial, which evaluated durvalumab consolidation therapy after ccrt in unresectable la nsclc, demonstrated a statistically significant and clinically meaningful improvement in progression-free survival (pfs) and a significant improvement in os. Durvalumab thus fills a critical unmet need in the setting of unresectable la nsclc and provides a new option for patients treated with curative intent. Here, we review the treatment of unresectable la nsclc, with a focus on the effect of the clinical data for durvalumab.
十多年来,无法切除的局部晚期(la)非小细胞肺癌(nsclc)患者的治疗结果没有改善。该情况下的标准治疗是确定性同步化疗和放疗(ccrt)。尽管治疗的目的是治愈,但大多数患者迅速进展,预后较差,5 年总生存率(os)在 15%-25%范围内。因此,这些患者代表着一个关键的未满足的需求,需要加快批准和获得新的治疗方法,以改善结果。太平洋试验评估了 ccrt 后 durvalumab 巩固治疗在不可切除的 la nsclc 中的疗效,结果显示无进展生存期(pfs)有统计学意义和临床意义的改善,总生存期(os)也有显著改善。因此,durvalumab 在不可切除的 la nsclc 中填补了一个关键的未满足的需求,并为接受治愈性治疗的患者提供了一种新的选择。在这里,我们回顾了不可切除的 la nsclc 的治疗方法,重点介绍了 durvalumab 的临床数据的影响。