BC Cancer, Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada.
Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Ch Ste-Foy, Québec, QC G1V 4G5, Canada.
Curr Oncol. 2023 Aug 8;30(8):7499-7507. doi: 10.3390/curroncol30080543.
Adjuvant durvalumab after chemoradiotherapy (CRT) is the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). A post hoc exploratory analysis of PACIFIC revealed no OS benefit in the PD-L1 < 1% subgroup. This retrospective analysis assesses the real-world impact of durvalumab on OS according to PD-L1 tumor proportion score (TPS). Patients with stage III, unresectable NSCLC treated by CRT, with available PD-L1 TPS, from 1 March 2018 to 31 December 2020, at BC Cancer, British Columbia, Canada were included. Patients were divided into two groups, CRT + durvalumab and CRT alone. OS and PFS were analyzed in the PD-L1 ≥ 1% and <1% subgroups. A total of 134 patients were included in the CRT + durvalumab group and 117, in the CRT alone group. Median OS was 35.9 months in the CRT + durvalumab group and 27.4 months in the CRT alone group [HR 0.59 (95% CI 0.42-0.83), = 0.003]. Durvalumab improved OS in the PD-L1 ≥ 1% [HR 0.53 (95% CI 0.34-0.81), = 0.003, = 175], but not in the <1% subgroup [HR 0.79 (95% CI 0.44-1.42), = 0.4, = 76]. This retrospective study demonstrates a statistically significant improvement in OS associated with durvalumab after CRT in PD-L1 ≥ 1%, but not PD-L1 < 1% NSCLC. Variables not accounted for may have biased the survival analysis. A prospective study would bring more insight.
在放化疗(CRT)后使用辅助度伐利尤单抗是不可切除 III 期非小细胞肺癌(NSCLC)的标准治疗方法。PACIFIC 的事后探索性分析显示,PD-L1<1%亚组的总生存期(OS)没有获益。本回顾性分析根据 PD-L1 肿瘤比例评分(TPS)评估度伐利尤单抗对 OS 的实际影响。纳入 2018 年 3 月 1 日至 2020 年 12 月 31 日期间,在加拿大不列颠哥伦比亚省不列颠哥伦比亚癌症中心接受 CRT 治疗、有 PD-L1 TPS 数据的不可切除 III 期 NSCLC 患者。患者分为 CRT+度伐利尤单抗组和 CRT 组。在 PD-L1≥1%和<1%亚组中分析 OS 和无进展生存期(PFS)。CRT+度伐利尤单抗组纳入 134 例患者,CRT 组纳入 117 例患者。CRT+度伐利尤单抗组的中位 OS 为 35.9 个月,CRT 组为 27.4 个月[风险比(HR)0.59(95%置信区间 0.42-0.83),=0.003]。度伐利尤单抗提高了 PD-L1≥1%患者的 OS[HR 0.53(95%置信区间 0.34-0.81),=0.003,=175],但在 PD-L1<1%亚组中没有[HR 0.79(95%置信区间 0.44-1.42),=0.4,=76]。本回顾性研究表明,在 PD-L1≥1%的 NSCLC 患者中,CRT 后使用度伐利尤单抗与 OS 显著改善相关,但在 PD-L1<1%的 NSCLC 患者中没有改善。未考虑到的变量可能会使生存分析产生偏差。前瞻性研究将提供更多的见解。