Labrie Valérie, Lefebvre Judith, Labbé Catherine, Jao Kevin, Malick Mandy, Simard Serge, Bouchard Nicole
Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke (CIUSSS de l'Estrie-CHUS), Sherbrooke, QC, Canada.
Respirology Department, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Québec, QC, Canada.
Front Oncol. 2024 Dec 12;14:1506172. doi: 10.3389/fonc.2024.1506172. eCollection 2024.
Consolidation durvalumab post chemo-radiotherapy (CRT) has been demonstrated to improve survival in locally advanced non-small-cell lung cancer (NSCLC). Real-world data to assess its use and impact on patients, particularly in Quebec, remain limited.
We, therefore, aimed to assess real-world durvalumab use in inoperable stage III NSCLC in Quebec, to describe progression-free survival (PFS) and overall survival (OS) outcomes as reported in the PACIFIC trial, and to evaluate safety and toxicity. Patients were retrospectively reviewed between January 1rst 2019 and December 31st 2020, based on their oncology reference date.
One hundred and eight patients treated with CRT were included, among which 82 received durvalumab (75.9%). The mean duration of treatment was 48 weeks [4-52], and 55% of patients completed the full treatment. Median PFS was 40 months in patients treated with CRT + durvalumab vs 6.9 months with CRT alone, with a hazard ratio (HR) of 0.22 (95% confidence interval (CI) 0.13-0.37; p < 0.0001). Limited access to CT scanning during the COVID pandemic, might have led to delayed disease progression detection and thus prolonged PFS. Median OS was > 52.8 months with CRT + durvalumab vs 19 months with CRT alone (HR 0.33, 95% CI 0.18-0.60; p=0.0002).
These findings support the efficacy and safety profile of durvalumab in real-world settings.
化疗放疗（CRT）后使用度伐利尤单抗已被证明可提高局部晚期非小细胞肺癌（NSCLC）患者的生存率。评估其使用情况及其对患者影响的真实世界数据，尤其是在魁北克地区，仍然有限。
因此，我们旨在评估魁北克不可切除的III期NSCLC患者中真实世界的度伐利尤单抗使用情况，描述如PACIFIC试验中所报告的无进展生存期（PFS）和总生存期（OS）结果，并评估安全性和毒性。根据患者的肿瘤学参考日期，对2019年1月1日至2020年12月31日期间的患者进行回顾性分析。
纳入了108例接受CRT治疗的患者，其中82例接受了度伐利尤单抗治疗（75.9%）。治疗的平均持续时间为48周[4 - 52周]，55%的患者完成了全程治疗。接受CRT + 度伐利尤单抗治疗的患者中位PFS为40个月，而仅接受CRT治疗的患者为6.9个月，风险比（HR）为0.22（95%置信区间（CI）0.13 - 0.37；p < 0.0001）。在新冠疫情期间CT扫描受限，可能导致疾病进展检测延迟，从而延长了PFS。接受CRT + 度伐利尤单抗治疗的患者中位OS > 52.8个月，而仅接受CRT治疗的患者为19个月（HR 0.33，95% CI 0.18 - 0.60；p = 0.0002）。
这些发现支持了度伐利尤单抗在真实世界环境中的疗效和安全性。
